Hypothermic Oxygenated Machine PErfusion During Ex-vivo SPLITting in Liver Pediatric Transplantation (HOPESPLIT) (HOPE SPLIT)
Hypothermic Oxygenated Machine PErfusion During Ex-vivo SPLITting in Liver Pediatric Transplantation (HOPE SPLIT): A Multicenter Randomized Controlled Trial
Ex-vivo split liver transplantation (SLT) has been developed to increase organ availability and offer a rapid access to transplantation for pediatric recipients. Given the fact that in-situ liver graft splitting is both technically and logistically very challenging, ex-vivo liver graft splitting is the most frequently performed procedure in SLT in France. Due to technical aspects inherent to the ex-vivo split, these partial grafts have prolonged static cold storage time, which negatively impacts graft survival despite the use of optimal donors. Hypothermic Oxygenated Perfusion (HOPE) of whole liver grafts prior to transplantation has been shown to optimize preservation by reducing static cold storage and consequently mitigating ischemia-reperfusion injury with a positive impact on post-LT outcomes. HOPE may thereby also benefit partial liver grafts from ex-vivo splits and improve outcomes in both pediatric and adult recipients.
Several trials assessing various modalities of liver machine perfusion have been conducted, but none have included partial grafts. Moreover, although the feasibility and safety of liver graft splitting during HOPE have been demonstrated in recent publications and by our group, robust data on its impact on split liver transplantation (SLT) outcomes are still lacking.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前:Guillaume ROSSIGNOL
- 電話番号:+33427856015
- メール:guillaume.rossignol@chu-lyon.fr
研究場所
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-
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Bron、フランス、69500
- Hospices Civils de Lyon - Hôpital Femme Mère Enfant
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コンタクト:
- Guillaume ROSSIGNOL
- メール:guillaume.rossignol@chu-lyon.fr
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主任研究者:
- Guillaume ROSSIGNOL
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Clichy、フランス、92210
- APHP Hopital Beaujon
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主任研究者:
- Mickael LESURTEL
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コンタクト:
- Mickael LESURTEL
- メール:mickael.lesurtel@aphp.fr
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Le Kremlin-Bicêtre、フランス、94270
- APHP Kremlin Bicetre
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コンタクト:
- Géraldine HERY
- メール:geraldine.hery@aphp.fr
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主任研究者:
- Géraldine HERY
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Lyon、フランス、69004
- Hospices Civils de Lyon - Hôpital de la Croix Rousse
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コンタクト:
- Guillaume ROSSIGNOL
- メール:guillaume.rossignol@chu-lyon.fr
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主任研究者:
- Guillaume Rossignol
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Paris、フランス、75013
- APHP Pitié Salpétrière
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コンタクト:
- Claire GOUMARD
- メール:claire.goumard@aphp.fr
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主任研究者:
- Claire GOUMARD
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Paris、フランス、75015
- APHP Hôpital Necker Enfants Malades
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コンタクト:
- Christophe CHARDOT
- メール:christophe.chardot@aphp.fr
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主任研究者:
- Christophe CHARDOT
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Villejuif、フランス、94804
- APHP Paul Brousse
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コンタクト:
- Marc-Antoine ALLARD
- メール:marcantoine.allard@aphp.fr
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主任研究者:
- Marc-Antoine ALLARD
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参加基準
適格基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Legal representatives of pediatric patients provide written informed consent prior to the performance of any study-specific procedure;
- Provide written informed consent of the adult recipient prior to the performance of any study-specific procedure;
- Donor liver graft procured from a brain-dead donor suitable for split liver transplantation and within the center specific selection criteria (Age, Weight, Body Mass Index, duration of Intensive Care Unit, Transaminases, vasopressive drugs, cardiac arrest, natremia);
- Hope split procedure performed ex situ by one of the participating center;
- Liver transplantation performed in the pediatric recipient by one of the participating centers.
Non inclusion Criteria:
- Splitting procedure performed in-situ
- Multi-organ transplantation (Liver-Kidney; Liver-Lung…)
- Grafts donated after circulatory arrest (DCD-Maastricht III)
- Patient participating in other interventional research, excluding routine care research (old regulation) and category 2 research not interfering with primary endpoint analysis
- Patients deprived of liberty by a judicial or administrative decision
- Persons under psychiatric care
- Persons admitted to a health or social institution for purposes other than research
- Adults subject to a legal protection measure (guardianship, curatorship)
- Persons not affiliated to a social security scheme or beneficiaries of a similar scheme
- Women of childbearing potential without access to contraception considered as highly effective
- Pregnant women, or women who are breastfeeding
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:HOPE group
Use of HOPE (End-ischemic Hypothermic Oxygenated Machine Perfusion) during ex vivo liver splitting |
In the experimental group, liver grafts will first undergo static cold (4°C) storage with preservation solution IGL-1 from graft procurement until arrival in the transplant center. Back table preparation of the liver graft followed by liver graft splitting will be performed during hypothermic oxygenated perfusion (HOPE) via the portal vein for a period of minimum 1 hour. In the HOPE-Split group, grafts will be preserved in Belzer-MPS solution maintained between 8 and 10°C during perfusion. Of note, both the right and left liver will be perfused until the respective recipient hepatectomies are completed. HOPE perfusion will be performed using the CE-certified VitaSmartTM Machine Perfusion System (Bridge to Life (Europe) Ltd, London) with Belzer UW Machine Perfusion Solution (MPS). |
|
アクティブコンパレータ:Classic static cold storage group
Standard splitting technique performed during static cold storage |
The control group will consist of a standard static cold storage (4°C) with preservation solution IGL-1 from graft procurement until liver implantation which is the actual gold standard procedure in liver transplantation. Back table preparation and splitting procedure will both be performed in IGL-1. |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
liver graft-related morbidity
時間枠:1 year
|
The primary endpoint is cumulative liver graft-related morbidity at 1 year after pediatric transplantation. The primary outcome measure will be the Comprehensive Complication Index which will be calculated as the total of all individual liver-related complications graded by the Clavien-Dindo score. |
1 year
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
その他の研究ID番号
- 69HCL22_0861
- 2025-A02005-44 (その他の識別子:ANSM)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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