CClinicalTrials.gg
RecruitingNCT07423936NONOFLOWUpdated Feb 20, 2026

Multimodal Neuromonitoring During Normothermic Regional Perfusion for Organ Donors Determined Dead by circuLatory Criteria Following Withdrawal of Life Sustaining Measures

An observational study in Organ Preservation and Brain Reperfusion or Regain of Brain Function During Normothermic Regional Perfusion, sponsored by University of British Columbia. Recruiting at 1 site in Canada. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2026-02-20.

Sponsored by University of British Columbia · Observational

From the registry’s dates

  • Started Feb 2025; still recruiting 1 year 7 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
30
Ages
19 Years and older
Sex
All
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Study summary

The aim of this study is to demonstrate that cerebral blood flow and brain function do not resume after death declaration in organ donors who undergo normothermic regional perfusion to restore organ function following death determination by circulatory criteria, when appropriate safeguards are applied.

To assess the absence of cerebral perfusion and function, investigators will use continuous and comprehensive multimodal neuromonitoring throughout the withdrawal of life-sustaining therapies, the dying process and the NRP procedure.

Read the detailed description

This will be a proof-of-concept study aimed at establishing the feasibility of multimodal neuromonitoring in patient undergoing abdominal (A-NRP) and thoraco-abdominal (TA-NRP) and to investigate whether resumption of CBF or function occurs in a cohort of DCD organ donors during A-NRP and TA-NRP. A central goal of this study is to demonstrate the absence of cerebral blood flow and function following normothermic regional perfusion, thereby improving clinical confidence to its safety and maintenance of adherence to death determination in organ donors.

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Conditions studied

  • Organ Preservation
  • Brain Reperfusion or Regain of Brain Function During Normothermic Regional Perfusion

Keywords

  • Normothermic regional perfusion
  • donation after cardiac death
  • organ donation
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In context

Lead sponsor

University of British Columbia is the lead sponsor of 1,309 studies on the registry; 253 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 1 (17%) have results posted.

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

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Who can participate

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

Study population

Consented eligible organ donors

Inclusion criteria

  1. Age > 18;
  2. Planned DCD within the next 96 hours.

Exclusion criteria

Exclusion Criteria:

  1. Coagulopathy (International normalized ratio > 1.5, prothrombin time > 45 seconds, platelets \< 50);
  2. Therapeutic anticoagulant medication administration.
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Study design

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

Groups and cohorts

  • Consented Organ Donors

    Consented for organ donation following withdrawal of life-sustaining measures and planned DCD within the next 96 hours.

    Other: Neuromonitoring

Interventions

  • OtherNeuromonitoring

    Neuromonitoring during withdrawal of life sustaining therapies, dying process and during normothermic regional perfusion after death. The neuromonitoring will include: * Invasive intracranial pressure monitoring (Codman) * Bilateral invasive oxygentation monitoring (Licox) * Bilateral invasive blood flow monitoring (Hemedex) * Bilateral invasive EEG monitoring (Nantus) * Cerebral microdialysis * Transcranial doppler (Novosignal) * Jugular bulb oximetry (Edwards) * Surface EEG (Nantus) * Near infrared spectroscopy (Masimo) * Somatosensory and brainstem evoked potentials * Bispectral index (Masimo)

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What researchers measure

Primary outcomes

  1. Aim 1: Assessment of brain reanimation (restoration of brain circulation and/or function)

    To determine the presence or absence of the brain circulation and function during normothermic regional perfusion assessed by intra-parenchymal neuromonitoring, non-invasive neuromonitoring and clinical examination. Reperfusion or regain of brain function during normothermic regional perfusion will be expressed in proportion. Restoration of either cerebral perfusion or neurological function in a patient will be considered a single brain reanimation event. Clinical examination will consist of serial pupillary light reflex assessment and monitoring for respiratory efforts during normothermic regional perfusion. Evidence of brain function will be determined by the presence of rhythmic delta wave activity on electroencephalography, N20 response with somatosensory evoked potentials or presence of brainstem auditory evoked potentials. Restoration of brain circulation will be determined by the presence of cerebral blood flow (\>10mls/100g/min) or brain tissue oxygen tension (\>2mmHg).

    Time frame: One hour prior to withdrawal of life-sustaining therapies, during the dying duration and for 2 hours during normothermic regional perfusion

  2. Aim 2: Feasibility of conducting multimodal monitoring

    To assess the feasibility of implementing multimodal neuromonitoring in DCD organ donors undergoing normothermic regional perfusion. This will be a descriptive outcome in which investigators will calculate the duration of available data for each modality and compare it with the total observation period. The investigators hypothesized that feasibility will be strong and that \> 80% data variables will be collected for the pre-specified duration in each case.

    Time frame: One hour prior to withdrawal of life-sustaining therapies, during the dying duration and for 2 hours during normothermic regional perfusion

Secondary outcomes

  1. Aim 3: To assess the agreement between invasive and non-invasive neuromonitoring in determining the presence or absence of brain reanimation during normothermic regional perfusion.

    To assess the agreement between invasive (intra-parenchymal cerebral blood flow, intra-parenchymal brain oxygenation, invasive EEG) and non invasive neuromonitoring (transcranial doppler, surface EEG, brainstem auditory evoked potentials, somatosensory evoked potentials) in determining the presence of brain circulation and function during normothermic regional perfusion

    Time frame: During normothermic regional perfusion

07

Study locations

1 of 1 sites recruiting
  • Vancouver General Hospital
    Vancouver, British Columbia V5Z1M9, Canada
    Recruiting
08

References and documents

Publications

  • Murphy N, Lingard L, Blackstock L, Ott M, Slessarev M, Basmaji J, Brahmania M, Healey A, Shemie S, Skaro A, Wilson L, Weijer C. Protocol for a qualitative pilot study to explore ethical issues and stakeholder trust in the use of normothermic regional perfusion in organ donation in Canada. BMJ Open. 2022 Sep 29;12(9):e067515. doi: 10.1136/bmjopen-2022-067515. PubMed 36175093 ↗
  • Murphy NB, Weijer C, Slessarev M, Chandler JA, Gofton T. Implications of the updated Canadian Death Determination Guidelines for organ donation interventions that restore circulation after determination of death by circulatory criteria. Can J Anaesth. 2023 Apr;70(4):591-595. doi: 10.1007/s12630-023-02413-6. Epub 2023 May 2. No abstract available. PubMed 37131028 ↗
  • Shemie SD, Wilson LC, Hornby L, Basmaji J, Baker AJ, Bensimon CM, Chandler JA, Chasse M, Dawson R, Dhanani S, Mooney OT, Sarti AJ, Simpson C, Teitelbaum J, Torrance S, Boyd JG, Brennan J, Brewster H, Carignan R, Dawe KJ, Doig CJ, Elliott-Pohl K, Gofton TE, Hartwick M, Healey A, Honarmand K, Hornby K, Isac G, Kanji A, Kawchuk J, Klowak JA, Kramer AH, Kromm J, LeBlanc AE, Lee-Ameduri K, Lee LA, Leeies M, Lewis A, Manara A, Matheson S, McKinnon NKA, Murphy N, Briard JN, Pope TM, Sekhon MS, Shanker JJS, Singh G, Singh J, Slessarev M, Soliman K, Sutherland S, Weiss MJ, Shaul RZ, Zuckier LS, Zorko DJ, Rochwerg B. A brain-based definition of death and criteria for its determination after arrest of circulation or neurologic function in Canada: a 2023 clinical practice guideline. Can J Anaesth. 2023 Apr;70(4):483-557. doi: 10.1007/s12630-023-02431-4. Epub 2023 May 2. PubMed 37131020 ↗
  • Shapey IM, Summers A, Augustine T, van Dellen D. Systematic review to assess the possibility of return of cerebral and cardiac activity after normothermic regional perfusion for donors after circulatory death. Br J Surg. 2019 Feb;106(3):174-180. doi: 10.1002/bjs.11046. Epub 2019 Jan 22. PubMed 30667536 ↗
  • Peled H, Mathews S, Rhodes D, Bernat JL. Normothermic Regional Perfusion Requires Careful Ethical Analysis Before Adoption Into Donation After Circulatory Determination of Death. Crit Care Med. 2022 Nov 1;50(11):1644-1648. doi: 10.1097/CCM.0000000000005632. Epub 2022 Oct 13. No abstract available. PubMed 36227032 ↗
  • Manara A, Shemie SD, Large S, Healey A, Baker A, Badiwala M, Berman M, Butler AJ, Chaudhury P, Dark J, Forsythe J, Freed DH, Gardiner D, Harvey D, Hornby L, MacLean J, Messer S, Oniscu GC, Simpson C, Teitelbaum J, Torrance S, Wilson LC, Watson CJE. Maintaining the permanence principle for death during in situ normothermic regional perfusion for donation after circulatory death organ recovery: A United Kingdom and Canadian proposal. Am J Transplant. 2020 Aug;20(8):2017-2025. doi: 10.1111/ajt.15775. Epub 2020 Jan 27. PubMed 31922653 ↗
  • van de Leemkolk FEM, Schurink IJ, Dekkers OM, Oniscu GC, Alwayn IPJ, Ploeg RJ, de Jonge J, Huurman VAL. Abdominal Normothermic Regional Perfusion in Donation After Circulatory Death: A Systematic Review and Critical Appraisal. Transplantation. 2020 Sep;104(9):1776-1791. doi: 10.1097/TP.0000000000003345. PubMed 32541563 ↗
  • Shapey IM, Muiesan P. Regional perfusion by extracorporeal membrane oxygenation of abdominal organs from donors after circulatory death: a systematic review. Liver Transpl. 2013 Dec;19(12):1292-303. doi: 10.1002/lt.23771. PubMed 24136827 ↗
  • Hessheimer AJ, de la Rosa G, Gastaca M, Ruiz P, Otero A, Gomez M, Alconchel F, Ramirez P, Bosca A, Lopez-Andujar R, Atutxa L, Royo-Villanova M, Sanchez B, Santoyo J, Marin LM, Gomez-Bravo MA, Mosteiro F, Villegas Herrera MT, Villar Del Moral J, Gonzalez-Abos C, Vidal B, Lopez-Dominguez J, Llado L, Roldan J, Justo I, Jimenez C, Lopez-Monclus J, Sanchez-Turrion V, Rodriguez-Laiz G, Velasco Sanchez E, Lopez-Baena JA, Caralt M, Charco R, Tome S, Varo E, Marti-Cruchaga P, Rotellar F, Varona MA, Barrera M, Rodriguez-Sanjuan JC, Briceno J, Lopez D, Blanco G, Nuno J, Pacheco D, Coll E, Dominguez-Gil B, Fondevila C. Abdominal normothermic regional perfusion in controlled donation after circulatory determination of death liver transplantation: Outcomes and risk factors for graft loss. Am J Transplant. 2022 Apr;22(4):1169-1181. doi: 10.1111/ajt.16899. Epub 2021 Dec 21. PubMed 34856070 ↗
  • Basmaji J, Weijer C, Skaro A, Healey A, Shemie SD, Slessarev M. Paving the Road for the Adoption of Normothermic Regional Perfusion in Canada. Crit Care Explor. 2021 Oct 28;3(11):e0553. doi: 10.1097/CCE.0000000000000553. eCollection 2021 Nov. PubMed 34729491 ↗
  • Ivanics T, Shwaartz C, Claasen MPAW, Patel MS, Yoon P, Raschzok N, Wallace D, Muaddi H, Murillo Perez CF, Hansen BE, Selzner N, Sapisochin G. Trends in indications and outcomes of liver transplantation in Canada: A multicenter retrospective study. Transpl Int. 2021 Aug;34(8):1444-1454. doi: 10.1111/tri.13903. Epub 2021 Jul 7. PubMed 33977568 ↗
  • Schaapherder A, Wijermars LGM, de Vries DK, de Vries APJ, Bemelman FJ, van de Wetering J, van Zuilen AD, Christiaans MHL, Hilbrands LH, Baas MC, Nurmohamed AS, Berger SP, Alwayn IP, Bastiaannet E, Lindeman JHN. Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation. EClinicalMedicine. 2018 Oct 9;4-5:25-31. doi: 10.1016/j.eclinm.2018.09.007. eCollection 2018 Oct-Nov. PubMed 31193600 ↗
  • Bleszynski MS, Parmentier C, Torres-Hernandez A, Ray S, Yousuf A, Norgate A, Schiff J, Shwaartz C, Sapisochin G, McGilvray I, Selzner M, Reichman TW. Pancreas transplantation with grafts obtained from donation after cardiac death or donation after brain death results in comparable outcomes. Front Transplant. 2023 Aug 9;2:1176398. doi: 10.3389/frtra.2023.1176398. eCollection 2023. PubMed 38993888 ↗
  • Palleschi A, Rosso L, Musso V, Rimessi A, Bonitta G, Nosotti M. Lung transplantation from donation after controlled cardiocirculatory death. Systematic review and meta-analysis. Transplant Rev (Orlando). 2020 Jan;34(1):100513. doi: 10.1016/j.trre.2019.100513. Epub 2019 Oct 18. PubMed 31718887 ↗
  • Haque OJ, Roth EM, Fleishman A, Eckhoff DE, Khwaja K. Long-Term Outcomes of Early Experience in Donation After Circulatory Death Liver Transplantation: Outcomes at 10 Years. Ann Transplant. 2021 Apr 20;26:e930243. doi: 10.12659/AOT.930243. PubMed 33875633 ↗
  • Tang JX, Na N, Li JJ, Fan L, Weng RH, Jiang N. Outcomes of Controlled Donation After Cardiac Death Compared With Donation After Brain Death in Liver Transplantation: A Systematic Review and Meta-analysis. Transplant Proc. 2018 Jan-Feb;50(1):33-41. doi: 10.1016/j.transproceed.2017.11.034. PubMed 29407328 ↗

Individual participant data

Plan to share: Undecided

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 20, 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
NCT07423936
Lead sponsor
University of British Columbia
Responsible party
Myp Sekhon (Principal investigator and clinical professor, MD, PhD, University of British Columbia) — Principal investigator
First posted
Feb 20, 2026
Start date
Feb 24, 2025
Primary completion
Sep 2028 (estimated)
Completion
Dec 2028 (estimated)
Last update
Feb 20, 2026

Study contacts

Rebecca Grey Clinical Research Coordinator
Contact
cerebri.research@ubc.ca
604-875-4111 ext. 68336

Oversight

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

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