HOPE for Small grafts in Living Donor Liver Transplantatio

Not Applicable

Conditions: Health Condition 1: - Health Condition 2: O- Medical and Surgical

Recruitment & Eligibility

Inclusion Criteria

Donor criteria:

1.Any living liver donor used for transplantation at Dr. Rela institute within the study period

2.Any type of donation surgery (open, robotic,..)

3.Any liver lobe (right, left)

4.GRWR <0.7 (study arm II: cold storage with 2hrs HOPE) and =0.7 (Study arm I: standard cold storage)

Recipient Criteria:

1.Adult recipient (=18years of age) of living related liver transplantation at Dr. Rela Institute

2.Primary liver transplantation

3.Donor-recipient ABO compatible or incompatible

4.Lab MELD of =25points

5.Recipient with any chronic liver disease with or without cirrhosis with or without liver tumour (HCC, or other)

6.Consented recipient

Exclusion Criteria

1.Recipient listed due to acute or subacute liver failure

2.Recipient listed for retransplantation

3.Recipients with known grade III or IV portal vein thrombosis

4.Recipients with combined transplantation (e.g., liver + kidney, liver + any other organ)

Recipients with lab MELD >25points

5.Recipients with sepsis (ICU requirement) at the time of transplantation

6.Recipients with ventilation at time of transplantation

Primary Outcome Measures

Name	Time	Method
Primary Endpoint: <br/ ><br>SFSS (Small for size Syndrome) , EAD (Early Allograft Dysfunction )Timepoint: 3 months

Secondary Outcome Measures

Name	Time	Method
1.Need for intraoperative flow modulation (surgical: Splenic Artery Ligation, Splenic Embolisation, Porto caval-shunt, pharmacological…) or postop interventions <br/ ><br>2.Intraoperative RBC, FFP trasnfusions <br/ ><br>3.Lactate end of Orthotopic Liver Trasnplantation(OLT), pharmacological support end of OLT <br/ ><br>4.HOPE perfusate: FMN, NADH, oxygenation <br/ ><br>5.ICU, hospital stay <br/ ><br>6.Transaminases 1st week including peak <br/ ><br>7. INR 12 and 24hrs and day 7 after OLT <br/ ><br>8.Lactate 6, 12, 24hrs after OLT <br/ ><br>9.Bilirubin day 7 <br/ ><br>10.AKI rate, need for dialysis/CVVH and duration <br/ ><br>11.Pharmacological support <br/ ><br>12.Biliary, vascular com1plications <br/ ><br>13.Sepsis/infection <br/ ><br>14.Major complication & CCI(comprehensive Complication Index in hospital, 3m, 12m after OLT <br/ ><br>15. Graft/patient survival within 1y after OLT <br/ ><br>Timepoint: in hospital, 3, 6, 9, 12 months