Direct Comparison of Normothermic Regional Perfusion, Dual Hypothermic Oxygenated Perfusion, and Controlled Oxygenated Rewarming NMP to Maximize Use of Extended Criteria Donor Livers After Donation After Circulatory Death in the Netherlands

What this Trial Is About

This research aims to improve the use of liver grafts from donors after circulatory death (DCD), particularly those with extended donor criteria (ECD) such as older age or certain medical conditions. There is a shortage of suitable liver grafts for transplantation, leading to patient deaths while waiting. The study evaluates different perfusion techniques to better preserve and test these donor livers, potentially increasing their successful use and improving patient and graft survival. The study compares three perfusion methods used in the Netherlands for DCD liver grafts from donors over 50 years old: normothermic regional perfusion (NRP), dual hypothermic oxygenated perfusion (DHOPE), and controlled oxygenated rewarming normothermic machine perfusion (COR-NMP). In the western region, NRP followed by DHOPE is used, while in the eastern and northern regions, standard rapid retrieval followed by DHOPE is done for donors aged 50-60, and COR-NMP is added for donors over 60. These techniques aim to restore blood flow, reduce organ damage, and assess organ viability before transplantation. Participants are adult liver transplant recipients who receive DCD liver grafts from donors aged 50 to 75 years. Researchers will track organ utilization rates, patient and graft survival, biliary complications, and cost-effectiveness over one year after transplantation. They will also monitor complications, waiting list times, and mortality. Data will be collected from multiple centers to compare outcomes between the perfusion techniques and improve organ preservation and transplant success.

NRP vs DHOPE vs COR-NMP in ECD-DCD Donation