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Assessing Declined Liver Grafts With Normothermic Machine Perfusion to Reduce Transplant Waiting Time
Sponsor: Charite University, Berlin, Germany
Summary
The goal of this study is to find out if quality assessment by normothermic machine perfusion can be used to safely increase the number of usable donor livers, helping more people get transplants faster and with better results. This process keeps a donated liver working outside the body before transplantation, allowing surgeons to assess whether livers previously considered unsuitable can still be used. The main questions this study aims to answer are: * Does this method help patients get a transplant sooner? * Can this method make more livers available for transplant? * Does it improve survival and health after transplant? Participants in this study must be on the waiting list for a liver transplant with a ReMELD-Na-Score of 21 or less (equivalent to MELD ≤25) and must not qualify for certain special exceptions. Participants will be randomly placed into one of two groups: * Experimental group: In addition to regular organ offers, these participants may receive a liver that was initially not considered for transplantation but meets quality standards after at least four hours of machine perfusion. * Control group: These participants will receive a liver through the usual transplant process. The main measure of success is how quickly participants receive a transplant. Researchers will also look at other important factors, such as survival rates, quality of life, hospital stay, and complications after transplant. This study may help improve liver transplantation by making better use of available donor livers, reducing waiting times, and improving patient outcomes.
Official title: Pilot, Open, Prospective, Randomized, Multicenter Trial On Quality Assessment Of Declined Liver Grafts By Normothermic Ex Vivo Machine Perfusion For Decreasing Time To Transplantation
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
186
Start Date
2025-06-02
Completion Date
2030-12-31
Last Updated
2026-02-03
Healthy Volunteers
No
Interventions
Quality Assessment with Normothermic Machine Perfusion (NMP)
Quality assessment using NMP in the experimental arm is performed according to previously published viability criteria for initially declined liver grafts, which are mandatory for all participating study centers, with minor device-specific modifications. These criteria are based on the Birmingham criteria used in the VITTAL trial for viability assessment of DBD and DCD grafts with the OrganOx Metra device and are comparable to the Groningen criteria used with the LiverAssist and PerLife device, with the exception of biliary viability. These criteria are: Lactate clearance \< 2.5 mmol/L, And two or more of the following: Evidence of bile production, maintenance of a perfusate pH \>7.30 (without correction for at least one hour), glucose metabolism (falling perfusate glucose value with consistent downward trend), maintenance of stable arterial and portal venous flows (OrganOx Metra: 150 and 500 mL/min respectively), homogeneous perfusion with soft consistency of the parenchyma.
Locations (9)
University Medical Center Hamburg-Eppendorf
Hamburg, Hamburg, Germany
University Hospital RWTH Aachen
Aachen, North Rhine-Westphalia, Germany
University Hospital Bonn
Bonn, North Rhine-Westphalia, Germany
University Hospital Muenster
Münster, North Rhine-Westphalia, Germany
Department of Surgery Campus Charité Mitte | Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin
Berlin, State of Berlin, Germany
Department of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich
München, Germany
Department of Surgery, University Hospital Regensburg
Regensburg, Germany
Eberhard Karls University of Tübingen, Department of General Visceral and Transplant Surgery
Tübingen, Germany
Department of General, Visceral, Transplantation, Vascular, and Pediatric Surgery, University Hospital Wurzburg
Würzburg, Germany