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Trial registered on ANZCTR
Registration number
ACTRN12625000521426p
Ethics application status
Submitted, not yet approved
Date submitted
5/05/2025
Date registered
26/05/2025
Date last updated
26/05/2025
Date data sharing statement initially provided
26/05/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Short versus long continuous oxygenated hypothermic machine perfusion (HMP) prior to kidney transplantation
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Scientific title
The efficacy of short versus prolonged continuous oxygenated hypothermic machine perfusion (HMP) prior to deceased donor kidney transplantation on delayed graft function
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Secondary ID [1]
314357
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None
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Universal Trial Number (UTN)
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Trial acronym
7n11 Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
End stage kidney disease
337349
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Condition category
Condition code
Surgery
333733
333733
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0
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Other surgery
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Renal and Urogenital
333732
333732
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Continuous oxygenated hypothermic machine perfusion (HMP) of the kidney prior to transplantation - long duration
Patients will be eligible for this arm of the study if their kidney transplant is anticipated to be reperfused after 1900 hours on the same day - in this case it will be left on HMP until 0800 the following day
This will be performed using the Kidney Assist Transporter Device (XVIVO)
The temperature will be maintained between 1-5 degrees C
The perfusion pressure will be set to 25 mmHg
Oxygen (100%) will be delivered at 100 ml/min
Perfusion will be commenced at the organ retrieval centre and continued until the patient is ready for transplant, and their iliac vessels have been dissected out
The retrieval surgeon will connect the kidney to the perfusion device, and along with a transplant perfusionist, will monitor it remotely during the period of perfusion
Device analytics will be accessed to obtain a summary of the overall perfusion record, including perfusion pressures and resistance
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Intervention code [1]
330974
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Treatment: Devices
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Comparator / control treatment
Continuous oxygenated hypothermic machine perfusion (HMP) of the kidney prior to transplantation - short duration (< 12 hours)
Patients will be eligible for this arm of the study if their kidney transplant is anticipated to be reperfused before 1900 hours on the same day - in this case it will be left on HMP until ready for transplantation on the same day
This will be performed using the Kidney Assist Transporter Device (XVIVO)
The temperature will be maintained between 1-5 degrees C
The perfusion pressure will be set to 25 mmHg
Oxygen (100%) will be delivered at 100 ml/min
Perfusion will be commenced at the organ retrieval centre and continued until the patient is ready for transplant, and their iliac vessels have been dissected out
The retrieval surgeon will connect the kidney to the perfusion device, and along with a transplant perfusionist, will monitor it remotely during the period of perfusion
Device analytics will be accessed to obtain a summary of the overall perfusion record, including perfusion pressures and resistance
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Control group
Active
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Outcomes
Primary outcome [1]
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Delayed graft function (DGF), as defined by the requirement for dialysis in the first week post-transplantation
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Assessment method [1]
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Yes or no depending on whether the patient required dialysis in the 1st week post-transplantation - this will be assessed by accessing the patient's medical records
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Timepoint [1]
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7 days post-transplantation
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Secondary outcome [1]
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Duration of delayed graft function in days
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Assessment method [1]
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Duration of delayed graft function is the last day post-transplantation that the patient requires dialysis, if any - this will be assessed by accessing the patient's medical records
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Timepoint [1]
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Up to 3 months post-transplantation
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Secondary outcome [2]
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Patient survival at 12 months
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Assessment method [2]
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Review of medical and clinic records
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Timepoint [2]
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12 months post-transplantation
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Secondary outcome [3]
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Biopsy-proven acute rejection
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Assessment method [3]
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Biopsy performed if clinically indicated looking for any evidence of acute rejection
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Timepoint [3]
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Within 1st month post-transplantation
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Secondary outcome [4]
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Record yes or no if - urologic complications (composite of urine leak, urinary stenosis, and/or ureter reimplantation)
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Assessment method [4]
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On review of the patient's medical and operative records
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Timepoint [4]
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Up to 1 month post-transplantation
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Secondary outcome [5]
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Hospital length of stay
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Assessment method [5]
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Time in days for first transplant admission - this will be assessed by accessing the patient's medical records
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Timepoint [5]
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At time of initial hospital discharge post-transplant
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Secondary outcome [6]
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Serum creatinine at 1, 3, 6, and 12 months post-transplantation
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Assessment method [6]
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Blood tests
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Timepoint [6]
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1, 3, 6, and 12 months post-transplantation
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Secondary outcome [7]
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Serum eGFR at 1, 3, 6, and 12 months post-transplantation
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Assessment method [7]
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Blood tests
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Timepoint [7]
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1, 3, 6, and 12 months post-transplantation
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Secondary outcome [8]
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Graft survival at 12 months
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Assessment method [8]
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Graft failure defined as return to dialysis (after 1st 3 months post-transplantation) or re-transplantation - this will be assessed on the patient's medical record
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Timepoint [8]
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12 months post-transplantation
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Secondary outcome [9]
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Primary non-function
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Assessment method [9]
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Requirement for dialysis continues more than 3 months post-transplantation - this will be assessed on the patient's medical record
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Timepoint [9]
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Up to 3 months post-transplantation
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Secondary outcome [10]
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Creatinine reduction ratio on post-operative day 2 and post-operative day 5, calculated as follows: Creatinine day 1 = Serum Creatinine day 2 divided by Serum Creatinine day 1 Creatinine pre-transplant = Serum Creatinine day 5 divided by Serum Creatinine pre-transplant
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Assessment method [10]
447127
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Blood tests
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Timepoint [10]
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Day 2 and 5 post-transplantation
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Secondary outcome [11]
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Record yes or no if - arterial or venous thrombosis
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Assessment method [11]
447573
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Review of the patient's medical records, including graft ultrasound reports
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Timepoint [11]
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Any time within 1st month post transplantation
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Secondary outcome [12]
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Peri-operative complications - take-back to theatre
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Assessment method [12]
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Record yes or no if take-back to theatre, as indicated on the patient's medical records
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Timepoint [12]
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Up to 1 month post-transplantation
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Secondary outcome [13]
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Complications related to hypothermic machine perfusion
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Assessment method [13]
447136
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Graft loss during HMP, as observed by surgeon administering HMP, and recorded in the HMP data sheet
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Timepoint [13]
447136
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During entire period of hypothermic machine perfusion
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Eligibility
Key inclusion criteria
o All deceased donor kidneys (DCD or DBD) that are deemed suitable for transplantation
o All suitable recipients who are more than or equal to 18 years, and undergoing their first or second kidney transplant
o Organ donation in NSW, with involvement of the Westmead retrieval team
o All recipients who are able to provide informed consent
o In a paired kidney donation (i.e. both kidneys from the same donor are allocated for transplantation at Westmead), only a single kidney will be taken for HMP, and the contralateral kidney will undergo standard cold static storage (CS) alone prior to transplantation.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
o Multi-organ transplantation (e.g. simultaneous pancreas kidney transplantation, or dual kidney transplantation)
o Unable to place kidney on HMP device for any reason (e.g. technically unable to cannulate without significant leakage in system)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
11/08/2025
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Actual
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Date of last participant enrolment
Anticipated
9/08/2027
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Actual
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Date of last data collection
Anticipated
14/08/2028
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
27878
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Westmead Hospital - Westmead
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Recruitment postcode(s) [1]
44074
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2145 - Westmead
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Funding & Sponsors
Funding source category [1]
318882
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Hospital
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Name [1]
318882
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Westmead Hospital Foundation
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Address [1]
318882
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Country [1]
318882
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Australia
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Funding source category [2]
318877
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Hospital
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Name [2]
318877
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Westmead Hospital
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Address [2]
318877
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Country [2]
318877
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Australia
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Primary sponsor type
Hospital
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Name
Western Sydney Local Health District
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Address
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Country
Australia
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Secondary sponsor category [1]
321348
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None
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Name [1]
321348
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None
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Address [1]
321348
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Country [1]
321348
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
317491
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Nepean Blue Mountains Local Health District
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Ethics committee address [1]
317491
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https://www.nbmlhd.health.nsw.gov.au/researchoffice
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Ethics committee country [1]
317491
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Australia
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Date submitted for ethics approval [1]
317491
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05/05/2025
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Approval date [1]
317491
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Ethics approval number [1]
317491
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Summary
Brief summary
There is an ongoing shortage of suitable organs for transplantation, and as a result we are using more marginal/suboptimal donor kidneys, which tend to have inferior short and longer term outcomes. Technologies exist that can potentially improve the outcomes of such kidneys by reducing the injury that occurs to these kidneys during transportation/storage prior to transplantation. One such technology is oxygenated hypothermic machine perfusion (HMP). This technology is very commonly utilised overseas, and is also currently being used in Australia (in Brisbane and Melbourne). However, the evidence for HMP efficacy in Australasia is currently lacking, and overseas results are not necessarily translatable given we tend to have shorter preservation times in Australia compared to overseas. We aim to investigate the impacts of this technology in our local setting, comparing short duration of HMP to a more prolonged duration of HMP in kidney transplantation. We will initially perform a pilot study with 20 patients, but hope to expand this into a larger scale clinical trial at the conclusion of the current study.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Ahmer Hameed
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Address
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Westmead Hospital, Hawkesbury Rd Westmead, NSW 2145
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Country
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Australia
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Phone
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+61 2 8890 6962
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Fax
141222
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Email
141222
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[email protected]
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Contact person for public queries
Name
141223
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Ahmer Hameed
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Address
141223
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Westmead Hospital, Hawkesbury Rd Westmead, NSW 2145
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Country
141223
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Australia
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Phone
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+61 2 8890 5555
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Fax
141223
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Email
141223
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[email protected]
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Contact person for scientific queries
Name
141224
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Ahmer Hameed
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Address
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Westmead Hospital, Hawkesbury Rd Westmead, NSW 2145
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Country
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Australia
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Phone
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+61 2 8890 5555
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Fax
141224
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Email
141224
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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