Bridge to HOPE: Hypothermic Oxygenated Perfusion Versus Cold Storage Prior to Liver Transplantation

Overview

About this study

The purpose of this study is to evaluate the safety and effectiveness of the VitaSmart Liver Machine Perfusion System by comparing clinical outcomes in patients undergoing liver transplantation with ex-vivo liver preservation using static cold storage (SCS) followed by hypothermic oxygenated machine perfusion (HOPE) versus SCS only.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Donation after Brain Death (DBD) Liver Inclusion Criteria (one or more):

- Donor age 50-85 years

- Anticipated cold ischemia time 10-15 hours (excluding HOPE duration)

- Macrosteatosis 10-40%

- Terminal ALT 250-1500 IU/ml

- Peak ALT within 3 days 1000-3000 IU/ml

- Terminal total bilirubin 2-4 mg/dl

Donation after Brain Death (DBD) Liver Exclusion Criteria (one or more):

- Donor age <18 or >85 years

- Anticipated cold ischemia >15 hours

- Macrosteatosis >40%

- Terminal ALT >1500 IU/ml

- Peak ALT within 3 days >3000 IU/ml

- Terminal total bilirubin >4 mg/dl

- Presence of hemodynamic and/or anatomical donor abnormalities that, in the opinion of
the Investigator, make the liver allograft unsuitable for transplant into the
recipient subject

- Liver intended for split transplant

- Liver from living donor

- Donor terminal serum Na >160 mmol/L

Donation after Cardio-circulatory Death (DCD) Liver Inclusion Criteria (all):

- Donor age 18-60 years

- Anticipated cold ischemia time <12 hours (excluding HOPE duration)

- Functional warm ischemia time ≤35 minutes, defined as interval from the time of onset
of donor hypotension (MAP <50mmHg) until the time of donor cross clamp

- Macrosteatosis ≤20%

- Terminal ALT ≤500 IU/ml

- Peak ALT within 3 days ≤2000 IU/ml

- Terminal total bilirubin ≤3 mg/dl

Donation after Cardio-circulatory Death (DCD) Liver Exclusion Criteria (one or more):

- Presence of hemodynamic and/or anatomical donor abnormalities that, in the opinion of
the Investigator, make the liver allograft unsuitable for transplant into the
recipient subject

- Liver intended for split transplant

- Liver from living donor

- Donor terminal serum Na >160 mmol/L

Recipient Inclusion Criteria (one or more):

- Subject (or legally authorized representative) is able to provide informed consent and
HIPAA authorization

- Subject is male or female and at least 18 years of age

- Subject is registered as an active liver recipient on the UNOS waiting list for liver
transplantation

- Subject will undergo primary liver transplantation

- Subject is willing to comply with the study requirements and procedures

- Subject with hepatocellular carcinoma as indication for Orthotopic Liver
Transplantation; the tumor must be within Milan Criteria or down-staged to Milan
Criteria

Recipient Exclusion Criteria (one or more):

- Subject will undergo multiple organ transplantations (liver-kidney, liver-lung, etc.)

- Subject is listed for liver transplantation due to fulminant liver failure (UNOS
status 1A)

- Subject is pregnant

- Subject is on respiratory (ventilator dependent) and/or cardiocirculatory support
(requires at least one intravenous inotrope to maintain hemodynamics)

- Subject is enrolled in an interventional clinical trial with an investigational drug
or device

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Eligibility last updated 9/20/22. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Jacksonville, Fla.

Mayo Clinic principal investigator

Shennen Mao, M.D.

Closed for enrollment

Contact information:

Clinical Studies Unit

(904) 953-2255

More information

Publications

Publications are currently not available
.
CLS-20528849

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