An observational study in End-stage Liver Disease (ESLD), Acute Liver Failure and Liver Cirrhosis, sponsored by University Medical Center Groningen. Recruiting at 38 sites in 10 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-03.
Sponsored by University Medical Center Groningen · Observational
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.
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.
154 studies on the registry are indexed under End Stage Liver Disease; 30 are open to participants now.
This study's planned enrollment of 10,000 is above the median of 200 across 55 observational studies indexed under End Stage Liver Disease.
Browse End Stage Liver Disease studies →University Medical Center Groningen is the lead sponsor of 627 studies on the registry; 176 are open to participants now.
Counted across the registry records on this site, refreshed daily.
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.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Eligible MP protocols are:
Exclusion Criteria:
Endischemic single- or dual hypothermic oxygenated machine perfusion. Normothermic regional perfusion prior to single- or dual hypothermic oxygenated machine perfusion is eligible for inclusion.
Endischemic (back-to-base) normothermic machine perfusion. Normothermic regional perfusion prior to endischemic (back-to-base) normothermic machine perfusion is eligible for inclusion.
Continuous (device-to-donor) normothermic machine perfusion. Normothermic regional perfusion prior to continuous (device-to-donor) normothermic machine perfusion is eligible for inclusion.
Endischemic single or dual hypothermic oxygenated machine perfusion followed by controlled oxygenated rewarming and normothermic machine perfusion. Normothermic regional perfusion prior to HOPE-COR-NMP is eligible for inclusion.
Endischemic single or dual hypothermic oxygenated machine perfusion followed by normothermic machine perfusion. Normothermic regional perfusion prior to HOPE-NMP is eligible for inclusion.
Normothermic regional perfusion followed by static cold storage or any ex situ machine perfusion protocol.
Preservation with static cold storage only, not preceeded by NRP, nor followed by ex situ machine perfusion.
Death-censored graft survival
Defined as the time from liver transplantation until re-transplantation or death due to graft failure (analyzed using time-to-event methods).
Time frame: Actuarial survival 1-5 year post-transplantation
Overall patient survival
Defined as time from liver transplantation until re-transplantation or all-cause death (analyzed using time-to-event methods).
Time frame: Actuarial survival 1-5 year post-transplantation
Overall graft survival
Defined as time from liver transplantation until re-transplantation or all-cause death (analyzed using time-to-event methods)
Time frame: Actuarial survival 1-5 year post-transplantation
Incidence of major liver-related complications
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.
Time frame: within the transplant-related admission, and 1 year post-transplantation
Incidence of graft loss due to complications
Graft loss as a result of complications assessed separately for biliary complications, vascular complications, and rejection.
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Total number of clinically significant biliary complications
Total number of any biliary complications requiring interventions (Clavien-Dindo grade IIIa or higher).
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of biliary complications
Biliary complications include: * Post-transplant cholangiopathy * Anastomotic strictures * Biliary leakage
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of vascular complications
Vascular complications include: * Hepatic artery thrombosis * Portal vein thrombosis * Venous outflow tract obstruction
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of re-transplantation
Re-transplantation for any cause.
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of acute rejection
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of chronic rejection
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of recurrence of primary disease
Histologically or radiologically confirmed recurrence, including recurrence of malignancies
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of kidney injury
Kidney injury includes: * Acute kidney injury * New-onset chronic kidney disease
Time frame: within 1 year post-transplantation, up to 5 years post-transplantation
Incidence of primary non-function
Liver graft failure within the first 7 days of transplantation with patent liver vessels leading to re-transplantation or patient death
Time frame: up to 1 week post-transplantation
Patient-centered outcomes (measure of recovery and healthcare utilization)
Length of intensive care unit stay and length of initial hospital stay (starting at day of transplantation until day of discharge, measured in days)
Time frame: within 1 year post-transplantation
Plan to share: Undecided
No publications or documents are linked to this record.
Started Apr 2026 (actual). Primary completion is estimated for Dec 2026, 8 months after the start.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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