For persistent worlds to really be meaningful in D:OS, you would need respawning enemies and encounters, and you'd also need someone constantly maintaining the world and ensuring a constant flow of new content. Without that constant maintenance, your players would run out of things to do.

That is theoretically possible to do, but I think the biggest obstacle would be finding some kind of DM who has enough time to handle said constant maintenance in a game which, unlike Skyrim, does not have built-in systems to do that automatically.