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RecruitingNCT03193151INTERLIVERUpdated Jun 4, 2026

Diagnostic and Therapeutic Applications of Microarrays in Liver Transplantation

An observational study in Liver Dysfunction, sponsored by University of Alberta. Recruiting at 15 sites in 5 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-04.

Sponsored by University of Alberta · Observational

From the registry’s dates

  • Started Dec 2017; still recruiting 8 years 9 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
300
Ages
18 Years and older
Sex
All
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Study summary

INTERLIVER is a prospective observational study of the relationship of the molecular phenotype of 300 liver transplant biopsies to the histologic phenotype and the clinical features and outcomes. A segment of a biopsy performed as standard-of-care for indications, or by center protocol, will be used for gene expression study.

Read the detailed description

The current standard for biopsy-based diagnoses of dysfunction of liver transplants is histology (the Banff system), an arbitrary international empirical consensus based on lesions and rules, similar in principle to the kidney, heart, and lung histology systems. Recent data-driven approaches using molecular and conventional technologies indicate that such systems frequently produce incorrect diagnoses - perhaps 40-50% in abnormal kidney or heart transplant biopsies and even more in lung biopsies, with great potential for harm to patients due to inappropriate treatment.

To address this unmet need and improve diagnostics in the area of organ transplantation, the Alberta Transplant Applied Genomics Centre (ATAGC, University of Alberta) has developed a new diagnostic system - the Molecular Microscope® Diagnostic System (MMDx) that interprets biopsies in terms of their molecular phenotype, and combines the molecular and histopathological features of transplant biopsies, plus clinical and laboratory parameters, to create the first Integrated Diagnostic System. The MMDx, developed first in kidney transplant biopsies because phenotypes are well established, will now be adapted to liver transplant biopsies. The present study will develop a Reference Set of liver biopsies, adapt the MMDx system to assess and report molecular phenotype of liver biopsies; and validate and refine this system in 300 unselected prospectively collected for clinical indications and a standard of care biopsies from North American and European Centers. In addition to demonstrating the real-time feasibility and potential value of this System in patient care, the study will develop and optimize a transparent and user-friendly reporting format to communicate this information to clinicians and obtain detailed feedback to improve its utility.

Thanks to increasing interest and support from participating centers, INTERLIVER has already received 856 biopsies from 740 participants and will extend the Reference Set to 900 biopsies.

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Conditions studied

  • Liver Dysfunction

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Keywords

  • Liver transplant
  • global gene expression
  • molecular diagnostics
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In context

Liver Diseases

2,081 studies on the registry are indexed under Liver Diseases; 390 are open to participants now.

This study's planned enrollment of 300 is above the median of 167 across 681 observational studies indexed under Liver Diseases.

Browse Liver Diseases studies →

Lead sponsor

University of Alberta is the lead sponsor of 800 studies on the registry; 168 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

This study aims to recruit 300 biopsies from liver transplant patients for clinical indications and the standard of care biopsies.

Inclusion criteria

  • biopsy for clinical indications

Exclusion criteria

Exclusion Criteria:

  • no consent, pregnant women
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
300 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Interventions

  • Procedureliver biopsy

    5 mm fragment of liver transplant biopsy taken for clinical indication

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What researchers measure

Primary outcomes

  1. Assign molecular scores (probability) of T cell mediated rejection, antibody mediated rejection in liver transplant biopsies, in a reference set of 100 biopsies

    Based on the reference set, create molecular classifier that predicts antibody mediated and T cell mediated rejection for next 200 biopsies

    Time frame: two years

Secondary outcomes

  1. Assign in real time (two working days upon biopsy receipt) molecular scores (probability) of T cell mediated rejection and antibody mediated rejection.

    The molecular phenotype of a newly acquired sample predicts the histologic and clinical features of this sample when compared to the reference set.

    Time frame: 1 year

07

Study locations

1 of 15 sites recruiting
  • University of California San Francisco, Transplant Research Unit
    San Francisco, California 94143, United States
    Completed
  • Northwestern Memorial Hospital
    Chicago, Illinois 60611, United States
    Completed
  • University of Maryland School of Medicine
    Baltimore, Maryland 21201, United States
    Completed
  • Henry Ford Transplant Institute
    Detroit, Michigan 48202, United States
    Recruiting
  • Vanderbilt University Medical Center, Vanderbilt Transplant Center
    Nashville, Tennessee 37232, United States
    Withdrawn
  • Baylor University Medical Center, Annette C. and Harold C. Simmons Transplant Institute
    Dallas, Texas 75246, United States
    Completed
  • Transplant Surgery, VCU Medical Center
    Richmond, Virginia 23298, United States
    Completed
  • Division of Transplant Surgery, University of Washington
    Seattle, Washington 98195, United States
    Completed
  • Centenary Institute of Cancer Medicine & Cell Biology, Royal Prince Alfred Hospital
    Camperdown, NSW 2050, Australia
    Completed
  • University of Alberta, Laboratory Medicine and Pathology
    Edmonton, Alberta T6G 2R7, Canada
    Completed
  • Dep. of Nephrology, Transplantation & Internal Med., Samodzielny Publiczny Szpital Kliniczny im. A. Mieleckiego
    Katowice, 40-027, Poland
    Completed
  • Independent Public Composite Regional Hospital
    Szczecin, 71-455, Poland
    Completed
  • Warsaw Medical University, Jesus the Child Clinical Hospital
    Warsaw, 02-005, Poland
    Completed
  • Warsaw Medical University, Independent Public Clinical Hospital
    Warsaw, 02-097, Poland
    Completed
  • Institute for Liver Science, King's College London
    London, SE5 9NU, United Kingdom
    Completed
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References and documents

Publications

  • Madill-Thomsen KS, Halloran PF. Precision diagnostics in transplanted organs using microarray-assessed gene expression: concepts and technical methods of the Molecular Microscope(R) Diagnostic System (MMDx). Clin Sci (Lond). 2024 Jun 5;138(11):663-685. doi: 10.1042/CS20220530. PubMed 38819301 ↗
  • Madill-Thomsen KS, Gauthier PT, Abouljoud M, Bhati C, Bruno D, Ciszek M, Durlik M, Feng S, Foroncewicz B, Grat M, Jurczyk K, Levitsky J, McCaughan G, Maluf D, Montano-Loza A, Moonka D, Mucha K, Myslak M, Perkowska-Ptasinska A, Piecha G, Reichman T, Tronina O, Wawrzynowicz-Syczewska M, Zeair S, Halloran PF. Defining an NK Cell-enriched Rejection-like Phenotype in Liver Transplant Biopsies From the INTERLIVER Study. Transplantation. 2025 Aug 1;109(8):1367-1382. doi: 10.1097/TP.0000000000005269. Epub 2025 Jan 9. PubMed 39780312 ↗
  • Madill-Thomsen K, Abouljoud M, Bhati C, Ciszek M, Durlik M, Feng S, Foroncewicz B, Francis I, Grat M, Jurczyk K, Klintmalm G, Krasnodebski M, McCaughan G, Miquel R, Montano-Loza A, Moonka D, Mucha K, Myslak M, Paczek L, Perkowska-Ptasinska A, Piecha G, Reichman T, Sanchez-Fueyo A, Tronina O, Wawrzynowicz-Syczewska M, Wiecek A, Zieniewicz K, Halloran PF. The molecular diagnosis of rejection in liver transplant biopsies: First results of the INTERLIVER study. Am J Transplant. 2020 Aug;20(8):2156-2172. doi: 10.1111/ajt.15828. Epub 2020 Apr 9. PubMed 32090446 ↗
  • Madill-Thomsen KS, Abouljoud M, Bhati C, Ciszek M, Durlik M, Feng S, Foroncewicz B, Francis I, Grat M, Jurczyk K, Klintmalm G, Krasnodebski M, McCaughan G, Miquel R, Montano-Loza A, Moonka D, Mucha K, Myslak M, Paczek L, Perkowska-Ptasinska A, Piecha G, Reichman T, Sanchez-Fueyo A, Tronina O, Wawrzynowicz-Syczewska M, Wiecek A, Zieniewicz K, Halloran PF. The molecular phenotypes of injury, steatohepatitis, and fibrosis in liver transplant biopsies in the INTERLIVER study. Am J Transplant. 2022 Mar;22(3):909-926. doi: 10.1111/ajt.16890. Epub 2021 Dec 3. PubMed 34780106 ↗
  • Halloran PF. Integrating molecular and histologic interpretation of transplant biopsies. Clin Transplant. 2021 Apr;35(4):e14244. doi: 10.1111/ctr.14244. Epub 2021 Feb 17. No abstract available. PubMed 33595110 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 4, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03193151
Lead sponsor
University of Alberta
Responsible party
Philip Halloran (Distinguished Professor, University of Alberta) — Principal investigator
First posted
Jun 20, 2017
Start date
Dec 19, 2017
Primary completion
Dec 2027 (estimated)
Completion
Dec 2028 (estimated)
Last update
Jun 4, 2026

Study contacts

Konrad S Famulski, PhD
Contact
konrad@ualberta.ca
1 780 492 1725
Robert Polakowski, PhD
Contact
polakows@ualberta.ca
1 780 492 5091
Philip F Halloran, MD, PhD
principal investigator · University of Alberta

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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