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Establishing a Reference Framework for Outcomes After Machine-Preserved Liver Transplantation in Europe (REFRAME-MP)

4 de septiembre de 2026 actualizado por: University Medical Center Groningen

Establishing a Reference Framework for Outcomes After Machine-Preserved Liver Transplantation in Europe (REFRAME-MP)

Machine perfusion (MP) has become routine clinical practice in liver transplantation. However, as the field has matured, direct randomized comparisons between distinct MP modalities have become increasingly impractical, given that donor and graft characteristics often predetermine the optimal preservation strategy. Consequently, many studies continue to reference historical benchmark cohorts from the pre-perfusion era, or use risk scores developed before routine utilization of MP. These cohorts, while once valuable, fail to account for the paradigm shift that MP has introduced. Likewise, commonly used donor- and recipient-based risk scores were developed prior to the adoption of MP. While these scores aim to assess survival or morbidity after transplantation, none of them guide decisions about MP use or the most suitable perfusion protocol. As MP technologies continue to evolve there is a critical need for an updated reference framework that accurately reflects current clinical practice and captures the best achievable outcomes across all MP modalities.

Descripción general del estudio

Estado

Reclutamiento

Condiciones

Intervención / Tratamiento

Descripción detallada

The aim of this study is to establish a reference framework for liver transplantation outcomes in the era of routine clinical machine perfusion. In addition, based on the collected real-world observational data, a target trial emulation approach will be applied.

Tipo de estudio

De observación

Inscripción (Estimado)

10000

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Sabrina Stimmeder, MD
  • Número de teléfono: +31503612896‬
  • Correo electrónico: s.stimmeder@umcg.nl

Ubicaciones de estudio

  • Alemania
      • Essen, Alemania
        • Reclutamiento
        • University Hospital Essen
        • Contacto:
        • Investigador principal:
          • Ulf Neumann, MD, PhD
        • Sub-Investigador:
          • Zoltan Czigany, MD, PhD
  • Austria
      • Innsbruck, Austria
        • Aún no reclutando
        • Medical University of Innsbruck
        • Contacto:
        • Investigador principal:
          • Stefan Schneeberger, MD, PhD
      • Vienna, Austria
        • Aún no reclutando
        • Medical University of Vienna
        • Contacto:
        • Investigador principal:
          • Deniz Uluk, MD
  • Bélgica
      • Leuven, Bélgica
        • Aún no reclutando
        • University Hospitals Leuven
        • Contacto:
        • Investigador principal:
          • Diethard Monbaliu, MD, PhD
  • Italia
      • Torino, Italia
        • Reclutamiento
        • A.O.U. Città della Salute e della Scienza
        • Contacto:
        • Investigador principal:
          • Damiano Patrono, MD, PhD
  • Países Bajos
      • Groningen, Países Bajos
        • Reclutamiento
        • University Medical Center Groningen
        • Investigador principal:
          • Vincent E de Meijer, MD, PhD
        • Contacto:
          • Sabrina Stimmeder, MD
          • Número de teléfono: +31503612896‬
          • Correo electrónico: s.stimmeder@umcg.nl
  • Reino Unido
      • London, Reino Unido
        • Aún no reclutando
        • Royal Free London NHS Foundation Trust
        • Contacto:
        • Investigador principal:
          • David Nasralla, MD, PhD
      • London, Reino Unido
        • Aún no reclutando
        • King's College Hospital NHS Foundation Trust
        • Contacto:
        • Investigador principal:
          • Miriam Cortes Cerisuelo, MD, PhD
  • Suecia
      • Stockholm, Suecia
        • Aún no reclutando
        • Karolinska Institutet
        • Contacto:
          • Gabriel Oniscu, MD, PhD
          • Número de teléfono: +46852480000
          • Correo electrónico: gabriel.oniscu@ki.se
        • Investigador principal:
          • Gabriel Oniscu, MD, PhD
  • Suiza
      • Bern, Suiza
        • Aún no reclutando
        • Bern University Hospital
        • Investigador principal:
          • Philipp Dutkowski, MD, PhD
        • Contacto:

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto
  • Adulto Mayor

Acepta Voluntarios Saludables

No

Método de muestreo

Muestra no probabilística

Población de estudio

All postmortal livers accepted (transplanted and not-transplanted after machine perfusion) upon organ offer between 01.01.2021 and 31.12.2025 for patients >18 years at the time of liver transplantation.

Descripción

Inclusion Criteria:

  • All postmortal livers accepted (transplanted and not-transplanted after machine perfusion) upon organ offer for patients >18 years at the time of liver transplantation.
  • All donor types (DBD, DCD)
  • Preservation either with static cold storage alone or combined with machine perfusion (MP).
  • Donor livers underwent MP as part of routine clinical practice and the choice of perfusion protocol was made according to institutional standard practice.

  • Eligible MP protocols are:

    1. end-ischemic single- or dual hypothermic oxygenated MP [e(D)HOPE],
    2. end-ischemic (back-to-base) normothermic MP [eNMP],
    3. continuous (device-to-donor) normothermic MP [cNMP],
    4. e(D)HOPE followed by controlled oxygenated rewarming and normothermic MP [e(D)HOPE-COR-NMP)],
    5. e(D)HOPE followed by normothermic MP [e(D)HOPE-NMP], or
    6. Normothermic regional perfusion followed by SCS or an ex situ MP protocol.
  • A minimum follow-up of 12 months after liver transplantation is required.

Exclusion Criteria:

  • Livers that were allocated to a MP protocol as part of a prospective randomized or interventional clinical trial comparing different preservation techniques or any other invention.
  • Living donor liver transplantation

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Death-censored graft survival
Periodo de tiempo: Actuarial survival 1-5 year post-transplantation
Defined as the time from liver transplantation until re-transplantation or death due to graft failure (analyzed using time-to-event methods).
Actuarial survival 1-5 year post-transplantation
Overall patient survival
Periodo de tiempo: Actuarial survival 1-5 year post-transplantation
Defined as time from liver transplantation until re-transplantation or all-cause death (analyzed using time-to-event methods).
Actuarial survival 1-5 year post-transplantation

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Overall graft survival
Periodo de tiempo: Actuarial survival 1-5 year post-transplantation
Defined as time from liver transplantation until re-transplantation or all-cause death (analyzed using time-to-event methods)
Actuarial survival 1-5 year post-transplantation
Incidence of major liver-related complications
Periodo de tiempo: within the transplant-related admission, and 1 year post-transplantation
Incidence of at least one biliary or vascular complication graded as Clavien-Dindo IIIb or higher, following the grading recommendations published: de Goeij FHC, Wehrle CJ, Abbassi F, et al. Mastering the narrative: Precision reporting of risk and outcomes in liver transplantation. J Hepatol. 2025;82(4):729-743. doi:10.1016/j.jhep.2024.11.013. Additionally, scoring accoring the Comprehensive Complication Index.
within the transplant-related admission, and 1 year post-transplantation
Incidence of graft loss due to complications
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation
Graft loss as a result of complications assessed separately for biliary complications, vascular complications, and rejection.
within 1 year post-transplantation, up to 5 years post-transplantation
Total number of clinically significant biliary complications
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation
Total number of any biliary complications requiring interventions (Clavien-Dindo grade IIIa or higher).
within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of biliary complications
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation

Biliary complications include:

  • Post-transplant cholangiopathy
  • Anastomotic strictures
  • Biliary leakage
within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of vascular complications
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation

Vascular complications include:

  • Hepatic artery thrombosis
  • Portal vein thrombosis
  • Venous outflow tract obstruction
within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of re-transplantation
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation
Re-transplantation for any cause.
within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of acute rejection
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation
within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of chronic rejection
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation
within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of recurrence of primary disease
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation
Histologically or radiologically confirmed recurrence, including recurrence of malignancies
within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of kidney injury
Periodo de tiempo: within 1 year post-transplantation, up to 5 years post-transplantation

Kidney injury includes:

  • Acute kidney injury
  • New-onset chronic kidney disease
within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of primary non-function
Periodo de tiempo: up to 1 week post-transplantation
Liver graft failure within the first 7 days of transplantation with patent liver vessels leading to re-transplantation or patient death
up to 1 week post-transplantation
Patient-centered outcomes (measure of recovery and healthcare utilization)
Periodo de tiempo: within 1 year post-transplantation
Length of intensive care unit stay and length of initial hospital stay (starting at day of transplantation until day of discharge, measured in days)
within 1 year post-transplantation

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

University Medical Center Groningen

Colaboradores

A.O.U. Città della Salute e della Scienza

Investigadores

  • Investigador principal: Vincent E de Meijer, MD, PhD, University Medical Center Groningen

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

21 de abril de 2026

Finalización primaria (Estimado)

31 de diciembre de 2026

Finalización del estudio (Estimado)

31 de diciembre de 2030

Fechas de registro del estudio

Enviado por primera vez

21 de abril de 2026

Primero enviado que cumplió con los criterios de control de calidad

11 de mayo de 2026

Publicado por primera vez (Actual)

14 de mayo de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

10 de septiembre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

4 de septiembre de 2026

Última verificación

1 de abril de 2026

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • UMCG_REFRAME-MP
  • METc 2026/180 (Identificador de registro: UMCG METc number)

Plan de datos de participantes individuales (IPD)

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INDECISO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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