- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05045794
Bridge to HOPE: Hypothermic Oxygenated Perfusion Versus Cold Storage Prior to Liver Transplantation
A Multicenter, Prospective, Open-label, Randomized Controlled Clinical Trial to Compare the Safety and Effectiveness of the VitaSmart Liver Machine Perfusion System With Static Cold Storage for Organ Preservation Prior to Liver Transplantation
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Patients on the UNOS waiting list for liver transplantation who have been consented, meet study eligibility criteria and are matched to a liver allograft from donation after brain death (DBD) or donation after circulatory death (DCD) that meet the extended risk eligibility criteria will be randomized 1:1 to SCS followed by HOPE (HOPE arm) or to SCS only (SCS arm). The objective of the study is to demonstrate the safety and effectiveness of the VitaSmart Liver Machine by comparing endpoints between the HOPE and SCS arms.
Following transplantation, patients will be monitored daily (labs, adverse events, medications/procedures) while inpatient, and then additionally on Days 14 and 30 and Months 3, 6 and 12. The primary efficacy endpoint of early allograft dysfunction (EAD) rate will be assessed between HOPE and control using a non-inferiority design. An interim analysis is planned after approximately 70% of patients have been completed primary endpoint data collection to assess for early study completion based on non-inferiority or superiority.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Chriss Stanford, MA
- Phone Number: 720-201-1640
- Email: c.stanford@b2ll.com
Study Contact Backup
- Name: Donna Corum
- Phone Number: 847-963-3070
- Email: d.corum@b2ll.com
Study Locations
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California
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San Bernardino, California, United States, 92408
- Loma Linda University Medical Center
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San Francisco, California, United States, 94143
- University of California San Francisco
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Stanford, California, United States, 94305
- Stanford University Medical Center
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Florida
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Jacksonville, Florida, United States, 32224
- Mayo Clinic
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Weston, Florida, United States, 33331
- Cleveland Clinic
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Indiana
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Indianapolis, Indiana, United States, 46202
- Indiana University
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Louisiana
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New Orleans, Louisiana, United States, 70121
- Ochsner Clinic Foundation
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Massachusetts
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Burlington, Massachusetts, United States, 01895
- Lahey Hospital and Medical Center
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Michigan
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Detroit, Michigan, United States, 48202
- Henry Ford Hospital
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Missouri
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Saint Louis, Missouri, United States, 63110
- Washington University St. Louis
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Nebraska
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Omaha, Nebraska, United States, 68198
- Nebraska Medical Center
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New York
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New York, New York, United States, 10029
- Mount Sinai Hospital
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Ohio
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Cleveland, Ohio, United States, 44195
- Cleveland Clinic
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Tennessee
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Nashville, Tennessee, United States, 37232
- Vanderbilt University Medical Center
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Texas
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Houston, Texas, United States, 77030
- Houston Methodist Hospital
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Wisconsin
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Madison, Wisconsin, United States, 53792
- University of Wisconsin Madison
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
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
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Hypothermic oxygenated perfusion (HOPE)
Ex-vivo donor liver preservation using static cold storage followed by HOPE using the VitaSmart Liver Machine
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Following donor liver retrieval, preservation using static cold storage, and back table preparation in the transplant center operating room, the organ will be flushed with Belzer UW Machine Perfusion Solution (MPS) and perfused through the cannulated portal vein using cold, actively oxygenated MPS that is circulated at low pressure for 90 minutes to 5 hours.
After disconnection from the device, donor liver implantation and reperfusion will proceed in accordance with institutional care standards.
Other Names:
Donor liver retrieval and preservation using standard of care cold storage methods
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Other: Static cold storage
Ex-vivo donor liver preservation using static cold storage only
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Donor liver retrieval and preservation using standard of care cold storage methods
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Proportion of patients with early allograft dysfunction (EAD)
Time Frame: At Day 7 post-transplant
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At Day 7 post-transplant
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Model for early allograft function (MEAF) score
Time Frame: Within 3 days post-transplant
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Based on definition by Olthoff et al, 2010 (doi: 10.1002/lt.22091)
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Within 3 days post-transplant
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Proportion of patients with primary non-function (PNF)
Time Frame: Within 7 days post-transplant
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Based on definition by Pareja et al, 2015 (doi: 10.1002/lt.23990)
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Within 7 days post-transplant
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Length of hospital stay
Time Frame: Up to study participation ends at 1-year follow-up
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Duration from initial ICU admission to hospital discharge order (measured in days)
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Up to study participation ends at 1-year follow-up
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Length of intensive care unit stay
Time Frame: Up to study participation ends at 1-year follow-up
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Duration from initial ICU admission to ICU discharge order (measured in days)
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Up to study participation ends at 1-year follow-up
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Duration on dialysis
Time Frame: Up to study participation ends at 1-year follow-up
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Duration from establishment of graft reperfusion until discontinuation of dialysis (measured in days)
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Up to study participation ends at 1-year follow-up
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Donor liver utilization rate
Time Frame: Up to study participation ends at 1-year follow-up
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Up to study participation ends at 1-year follow-up
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Patient survival rate
Time Frame: 30 days, 6 months, 1 year post-transplant
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30 days, 6 months, 1 year post-transplant
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Graft survival rate
Time Frame: 30 days, 6 months, 1 year post-transplant
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30 days, 6 months, 1 year post-transplant
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Incidence of adverse events (AEs)
Time Frame: 1 year post-transplant
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1 year post-transplant
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Incidence of serious AEs (SAEs)
Time Frame: 1 year post-transplant
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1 year post-transplant
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Incidence of unanticipated adverse device effects (UADEs)
Time Frame: 1 year post-transplant
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1 year post-transplant
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Incidence of ischemic cholangiopathy
Time Frame: 6 months, 1 year post-transplant
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6 months, 1 year post-transplant
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Incidence of biopsy-proven liver rejection
Time Frame: 6 months, 1 year post-transplant
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6 months, 1 year post-transplant
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: David Reich, MD, Drexel University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BTL-2020-01vs
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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