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

ID#: NCT05045794

Age: 18 years - 66+

Gender: All

Healthy Subjects: No

Study Phase: N/A

Recruitment Status: Recruiting

Start Date: December 16, 2021

End Date: November 30, 2024

Contact Information:
Donna Corum
847-963-3070
Chriss Stanford, MA
720-201-1640
Summary: This is a prospective, multi-center, controlled, randomized, pivotal study 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.
Eligibility: 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