18 Participants Needed

Machine Perfusion for Liver Transplant Preservation

CQ
KS
Overseen ByKevin Smith
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: The Cleveland Clinic
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method to preserve donor livers for transplant using a special machine. It combines cooling (hypothermic) and warming (normothermic) techniques to maintain liver health before surgery. Known as Sequential Hypo- and Normo-thermic Perfusion, this approach aims to improve the quality of livers from donors with extended criteria, which may not be perfect but remain usable. Individuals scheduled for a full liver transplant might be suitable candidates for this study. As an unphased trial, it offers a unique opportunity to contribute to innovative research that could enhance liver transplant outcomes.

What prior data suggests that this perfusion device is safe for liver transplantation?

Research has shown that using different temperature techniques to prepare livers for transplants is promising. In one study, 94% of the transplanted livers functioned well after a year, and all patients survived. Only 3% of patients experienced bile duct issues, the main problem observed. Overall, this method was well-tolerated, with no major safety concerns reported. These findings suggest that this approach is safe for preserving donor livers before transplantation.12345

Why are researchers excited about this trial?

Most liver transplant preservation methods rely on cold storage, which can limit the organ's viability and function. The treatment being explored, Sequential Hypo- and Normo-thermic Perfusion, is unique because it preserves liver grafts at both cold (hypothermic) and body-like (normothermic) temperatures using a specialized machine. This process maintains continuous oxygen delivery to the organ, potentially improving the liver's condition before transplantation. Researchers are excited because this method could enhance organ preservation, reduce damage, and increase the success rate of transplants compared to traditional cold storage techniques.

What evidence suggests that this perfusion device is effective for liver transplantation?

Research has shown that cold machine perfusion (HMP) helps preserve livers from donors who don't meet all the usual criteria. Warm machine perfusion (NMP) offers similar benefits and also allows doctors to assess the liver's condition. Studies have found that this method can increase the number of livers available for transplant. Specifically, one study found that using NMP improved the long-term survival of transplanted livers. This trial will evaluate the effectiveness of using both cold and warm perfusion in sequence, known as Sequential Hypo- and Normo-thermic Perfusion, as a method to prepare livers for transplant.13467

Who Is on the Research Team?

KH

Koji Hashimoto, MD, PhD

Principal Investigator

The Cleveland Clinic

Are You a Good Fit for This Trial?

This trial is for adults aged 18 or older who are undergoing liver transplantation and can follow the study's procedures. They must understand and sign a consent form. It's not open to those who don't speak the language well, have mental incapacities, need multiple organ transplants, or are receiving partial grafts.

Inclusion Criteria

I am undergoing a liver transplant.
I am willing and able to follow the study's requirements.
Signed Informed Consent Form

Exclusion Criteria

I have received multiple organ transplants.
I have received a partial organ transplant.
You are not able to understand the study procedures due to language differences.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Ex Vivo Organ Preservation

Liver grafts are preserved using hypothermic and normothermic machine perfusion with continuous oxygen supply

1-14 hours

Transplantation and Immediate Post-Transplant Care

Liver transplantation procedure followed by immediate post-transplant care according to clinical standards

1 month

Follow-up

Participants are monitored for safety and effectiveness after transplantation

12 months

What Are the Treatments Tested in This Trial?

Interventions

  • Sequential Hypo- and Normo-thermic Perfusion
Trial Overview The trial tests a new method of preserving donor livers using a special machine that cools them down (HMP) for 1-4 hours then warms them (NMP) for 1-14 hours before transplant. This technique aims to improve the condition of livers from donors that don't meet standard criteria.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Liver perfusionExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

The Cleveland Clinic

Lead Sponsor

Trials
1,072
Recruited
1,377,000+

Koji Hashimoto

Lead Sponsor

Trials
1
Recruited
20+

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/36302699/
Sequential hypothermic and normothermic perfusion ...The purpose of this study was to assess the safety and feasibility of sequential hypothermic oxygenated perfusion and normothermic machine perfusion.
Sequential hypothermic and normothermic machine ...We present the outcomes of sequential ex situ end‐ischemic DHOPE and NMP for high‐risk donor livers, comparing two protocols with two different oxygen carriers ...
Study Details | NCT04023773 | Sequential Hypo- and ...Hypothermic machine perfusion (HMP) has been shown to be beneficial to preserve extended criteria donor (ECD) livers for transplantation. Normothermic machine ...
Long-term outcomes after hypothermic oxygenated ...Our aim was to assess 5-year survival rates after transplantation of donor livers preserved by HOPE based on real-world data, in various patient.
Role of normothermic machine perfusion in liver ...Studies showed that using normothermic machine perfusion can increase the pool of transplantable discarded livers and is a promising strategy to improve graft ...
Sequential hypothermic and normothermic perfusion ...The purpose of this study was to assess the safety and feasibility of sequential hypothermic oxygenated perfusion and normothermic machine perfusion.
Excellent long-term outcomes after sequential hypothermic ...Excellent long-term outcomes after sequential hypothermic and normothermic machine perfusion challenges the importance of functional donor warm ischemia time ...
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