Please select the eligibility criteria that correspond to the clinical trial below.
Title: Clinical Impact of Hypothermic Machine Perfusion in Renal Transplant Recipients
Brief Summary: This is a multi-centers prospective, randomized, controlled trial. This trial will investigate the clinical outcome of kidney transplant recipients whose kidneys are under two different forms of organ preservation--hypothermic machine perfusion vs. static cold storage. Factors during the machine perfusion, such as the pressure, flow rate, and resistance index will also be investigated.


Options:
A: Inclusion Criteria:

* Donor

  1. Comply with the national DCD（donor after citizen death) guideline
  2. No high risk activities: such as history of drug abuse, history of intravenous drug use and risky sexual behavior
  3. No malignant melanoma, metastatic cancer, or incurable cancer; some of the early stages of cancer after a successful treatment can also be considered
  4. No active, untreated systemic bacterial, viral or fungal infection;
  5. Patients definitely identified
  6. Mechanical perfusion RI (resistance index ) \[0.18, 0.50\]

Recipient:

1. Age\> = 16 years old, male or female
2. BMI\<28
3. First Renal transplantation
4. Not in pregnancy or lactation, pregnancy test was negative, and promise not to be pregnant during treatment.
5. Before the clinical trial, Patient sign informed consent voluntarily

Exclusion Criteria:

* Donor

  1. Older than 50 years old
  2. Serum HBV (hepatitis B virus), HCV (hepatitis C virus), HIV positive
  3. Donor kidney cold storage time over 30 hours
  4. Warm ischemia time over 20 minutes
  5. Other reagents are added perfusion for regulation of donor renal function

Recipient:

1. Double organ or multi-organ transplant
2. Blood type-incompatible
3. Patients with other malignant diseases
B: Inclusion Criteria for marginal graft:

* donors over 60 years of age
* donors between 50 and 60 years of age with at least one of the following characteristics :

  * history of diabetes mellitus
  * history of high blood pressure
  * serum creatinine \>1,5 mg/dL
  * death by stroke (haemorrhagic or thrombotic)

Inclusion criteria for recipient :

* patients registered on the kidney transplant waiting list likely to receive a marginal kidney
* immunized patients whose anti-HLA antibody specificities have been determined

Exclusion Criteria for recipient:

* pregnant or breastfeeding women
* people who have been incarcerated
* minors
* adults under guardianship
* people who are not affiliated with the French healthcare system
* people with HLA immunization whose HLA antibody specificities have not been determined
C: Inclusion Criteria:

* Signed informed consent
* Patients 18 years or older
* Patients suffering from end-stage kidney disease / kidney failure
* Listed for kidney transplantation
* Receiving ECD-allograft

Exclusion Criteria:

* Recipients of living donor kidney transplants
* Previous kidney transplantation
* Combined transplantations (liver-kidney, kidney-pancreas, etc.)
* Participation in other kidney related trials
* Exposure to an investigational drug within 30 days prior to inclusion
* Unwilling or unable to follow the procedures outlined in the protocol
* Mentally or legally incapacitated
D: GRAFT:

Inclusion criteria:

DCD:

* no absolute contraindications as per Italian National Transplant center (CNT)
* donor age ≤70 years
* witnessed and documented cardiac arrest
* macro-vescicular steatosis \<30% at liver biopsy
* necrosis \<5% at liver biopsy
* fibrosis \<2 as per Ishak's score at liver biopsy
* arteriolar thickening \<60% at liver biopsy
* WIT ≤160 minutes
* ALT \<1000 UI/L during NRP
* downward trend lactate during NRP

DBD:

* no absolute contraindications as per Italian National Transplant center (CNT)
* donor age \> 70 years
* macro-steatosis between 30 and 50% at liver biopsy

Exclusion criteria:

DCD:

* absolute contraindications as per Italian National Transplant center (CNT)
* donor age \>70 years
* macro-vescicular steatosis \>30% at liver biopsy
* necrosis \>5% at liver biopsy
* fibrosis \>2 as per Ishak's score at liver biopsy
* severe macroangiopathy (arteriolar thickening \>60% at liver biopsy)
* WIT \>160 minutes
* ALT \>1000 UI/L during NRP
* uptrend lactate during NRP

DBD:

* absolute contraindications as per Italian National Transplant center (CNT)
* donor age \< 70 years
* macro-steatosis between \> 50% at liver biopsy

RECIPIENTS

Inclusion criteria:

* Subject must be greater than or equal to 18 years of age.
* Subject with end-stage liver disease who is actively listed for primary liver transplantation
* Subject, or a legally authorized representative, has given informed consent to participate in the study

Exclusion criteria:

* Subject is currently listed as a UNOS status 1A.
* Subject is requiring oxygen therapy via ventilator/respiratory support.
* Subject is planned to undergo simultaneous solid organ transplant.
* Subject is pregnant at the time of transplant.
* Subject MELD score 25 or higher
* Subject receives re-transplantation of liver.
* Any medical conditions contro-indicating the use of DCD grafts at transplant surgeon/hepatologist evaluation

Answer: A