Liver Transplantation After ex Vivo Liver Perfusion

Study Overview
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Brief Summary
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Today, it is difficult to predict liver function after transplantation and therefore livers where poor function is assumed (marginal livers) become discarded. The study aim is to increase the number of available donor livers, especially for liver cancer patients, by pre-treating and testing marginal ones (extended criteria donor (ECD) livers) liver on a liver perfusion machine. A liver perfusion machine can simulate liver transplantation and enables functional/quality testing before transplantation. The machine will hopefully also make marginal livers more functional by reducing ischemia- & reperfusion injury. A marginal donor liver is perfused ex situ with oxygenated blood from a blood donor on a machine. The liver can be tested here for function using internationally recognized criteria. At the same time, the investigators will carry out analyzes with microdialysis which can give a better picture of organ function and damage. Additionally, various samples of the liver and perfusate will be collected. Liver that achieves criteria for transplantation will be offered to the recipient.

Detailed Description
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The study is a single-center, prospective, open-label cohort study designed to determine the efficacy of liver perfusion of marginal ECD livers on a perfusion machine before liver transplantation. Donor livers will be preserved with standard cooling followed by three perfusion modes (Dual hypothermic oxygenated machine perfusion (DHOPE) / Controlled oxygenated rewarming (COR) / Normothermic machine perfusion (NMP)), a method used internationally to pre-treating marginal livers before liver transplantation and which able testing of function and quality before a transplantation is performed. Only livers that fulfill international criteria (Groningen criteria) will be approved for Ltx. In this study microdialysis will be used to monitoring the liver during machine perfusion and up to 14 days in the postoperative course to monitor the function of the liver. The hypothesis is that microdialysis will provide a better prediction of liver function than the existing Groeningen criteria. The investigators expect that most included patients, who receive ECD livers perfused on a machine, will receive a postoperative well-functioning liver graft which entails a significant survival benefit. The study is designed as a cohort study because included patients have a very poor prognosis (median overall survival of approx. 6 months) and others treatment options are lacking. The primary objective is to establish definitive, objective criteria for pre-transplant liver function by defining a threshold value for microdialysis parameters (especially lactate) between donor livers that will restore function and those that will not during ex vivo machine perfusion in ECD livers, which are superior to established criteria (Groeningen and Viability testing and transplantation of marginal livers (VITTAL) criteria)). The primary endpoint is microdialysis lactate level between donor livers after 4 hours of normothermic machine perfusion in ECD livers. The follow-up period is 12 months.

Official Title
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Liver Transplantation After ex Vivo Liver Perfusion - The EVOLVE Study

Conditions
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Liver Transplant; Complications, Transplant; Failure, Liver, Transplant Dysfunction, Transplant; Complication, Rejection, Transplant, Liver Metastases, Liver Cancer

Intervention / Treatment
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* Procedure: Liver transplantation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Signed informed consent ≥ 18 years Indication for liver transplantation (one criteria must be met): Colorectal cancer patients who have received 1st and 2nd line chemotherapy where the treatment has been stopped due to progression or toxicity and the patient is not eligible for SECA-2 (Survival Following Liver Transplantation for Patients With Nonresectable Liver-only Colorectal Metastases) study. Hepatocellular carcinoma patients who are not suitable for standard liver transplantation, liver resection or local treatment (Transarterial Chemoembolisation or Selective internal radiotherapy). The patients must have progression or intolerance (toxicity) for immune checkpoint inhibitors or 1st line treatment. Cholangiocarcinoma patients who have progression or intolerance to first-line chemotherapy. Benign liver disease with urgent need for transplantation within months, but no regular graft is available. Life expectancy ≤ 6 months Willing, able and expected cooperation to attend follow-up examinations Patients who have a need for liver transplantation but cannot participate in other transplant studies or participation in another clinical trial with randomization to liver transplantation. For malignant disease the following criteria must be met: Good performance status assessed at the discretion of the treating physician. ECOG (Eastern Cooperative Oncology Group) 0 or 1 Satisfactory blood tests Hemoglobin >8 g/dl Neutrophiles >1.0 (after any Granulocyte colony-stimulating factor) Platelets >75 Bilirubin <1.5 x upper normal level ASAT (Aspartate aminotransferase), ALAT (alanine aminotransferase) <5 x upper normal level Albumin above lower normal level. Exclusion Criteria: Already listed for ordinary Ltx with expectance of getting offered a regular liver graft within a reasonable time-frame. Patients included in the control arm of the SECA-3 study or the Excalibur studies except for the Ltx arm of the Excalibur I study. Mental conditions rendering the subject incapable to understand the nature, scope, and consequences of the trial. Any reason why, in the opinion of the investigator, the patient should not participate.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Single center, prospective, open, observational study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Liver transplanted patient<br>Patients who are transplanted with an ECD liver after pretreatment with a liver perfusion machine | Procedure: Liver transplantation<br>* Patients who receive an ECD liver after an ex-vivo liver perfusion where the liver has been tested for function and approved according to international functional criteria (Groeningen criteria)<br>|
| No Intervention: Non-liver transplanted patient<br>Patients who are not offered a liver transplantation during the inclusion period | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lactate level in microdialysate from hilar plate after normothermic machine perfusion - 4 hours | Lactate level in microdialysate from hilar plate after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lactate level in microdialysate from liver tissue after normothermic machine perfusion - 2.5 hours | Microdialysis lactate level in donor liver tissue after 2.5 hours of normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Lactate level in microdialysate from liver tissue after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Microdialysis lactate level in donor liver tissue after 2 hours of Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Pyruvate level in microdialysate from liver tissue after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Microdialysis pyruvate level in donor liver tissue after 2 hours of Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Glycerol level in microdialysate from liver tissue after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Microdialysis glycerol level in donor liver tissue after 2 hours of Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Glucose level in microdialysate from liver tissue after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Microdialysis glucose level in donor liver tissue after 2 hours of Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Lactate level in microdialysate from liver tissue after controlled oxygenated rewarming machine perfusion - 1 hour | Microdialysis lactate level in donor livers tissue after 1 hour of controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Glycerol level in microdialysate from liver tissue after controlled oxygenated rewarming machine perfusion - 1 hour | Microdialysis glycerol level in donor livers tissue after 1 hour of controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Glucose level in microdialysate from liver tissue after controlled oxygenated rewarming machine perfusion - 1 hour | Microdialysis glucose level in donor livers tissue after 1 hour of controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Pyruvate level in microdialysate from liver tissue after controlled oxygenated rewarming machine perfusion - 1 hour | Microdialysis pyruvate level in donor livers tissue after 1 hour of controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Glucose level in microdialysate from liver tissue after normothermic machine perfusion - 2.5 hours | Microdialysis glucose level in donor liver tissue after 2.5 hours of normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Glucose level in microdialysate from liver tissue after normothermic machine perfusion - 4 hours | Microdialysis glucose level in donor liver tissue after 4 hours of normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Pyruvate level in microdialysate from liver tissue after normothermic machine perfusion - 2.5 hours | Microdialysis pyruvate level in donor liver tissue after 2.5 hours of normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Pyruvate level in microdialysate from liver tissue after normothermic machine perfusion - 4 hours | Microdialysis pyruvate level in donor liver tissue after 4 hours of normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Glycerol level in microdialysate from liver tissue after normothermic machine perfusion - 2.5 hours | Microdialysis glycerol level in donor liver tissue after 2.5 hours of normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Glycerol level in microdialysate from liver tissue after normothermic machine perfusion - 4 hours | Microdialysis glycerol level in donor liver tissue after 4 hours of normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Lactate level in microdialysate from bile after normothermic machine perfusion - 4 hours | Microdialysis lactate level from bile after normothermic machine perfusion - 4 hours in extended criteria donors livers. | 4 hours | 
| Lactate level in microdialysate from bile after normothermic machine perfusion - 2.5 hours | Microdialysis lactate level from bile after normothermic machine perfusion - 2.5 hours in extended criteria donors livers. | 2.5 hours | 
| Glucose level in microdialysate from bile after normothermic machine perfusion - 4 hours | Microdialysis glucose levels from bile after normothermic machine perfusion - 4 hours in extended criteria donors livers. | 4 hours | 
| Glucose level in microdialysate from bile after normothermic machine perfusion - 2.5 hours | Microdialysis glucose levels from bile after normothermic machine perfusion - 2.5 hours in extended criteria donors livers. | 2.5 hours | 
| Pyruvate level in microdialysate from bile after normothermic machine perfusion - 4 hours | Microdialysis pyruvate levels from bile after normothermic machine perfusion - 4 hours in extended criteria donors livers. | 4 hours | 
| Pyruvate level in microdialysate from bile after normothermic machine perfusion - 2.5 hours | Microdialysis pyruvate levels from bile after normothermic machine perfusion - 2.5 hours in extended criteria donors livers. | 2.5 hours | 
| Glycerol level in microdialysate from bile after normothermic machine perfusion - 4 hours | Glycerol levels from bile after normothermic machine perfusion - 4 hours in extended criteria donors livers. | 4 hours | 
| Glycerol level in microdialysate from bile after normothermic machine perfusion - 2.5 hours | Glycerol levels from bile after normothermic machine perfusion - 2.5 hours in extended criteria donors livers. | 2.5 hours | 
| Glycerol level in microdialysate from bile after controlled oxygenated rewarming machine perfusion - 1 hour | Glycerol levels from bile after controlled oxygenated rewarming machine perfusion - 1 hour - in extended criteria donors livers. | 1 hour | 
| Glucose level in microdialysate from bile after controlled oxygenated rewarming machine perfusion - 1 hour | Glucose levels from bile after controlled oxygenated rewarming machine perfusion - 1 hour - in extended criteria donors livers. | 1 hour | 
| Lactate level in microdialysate from bile after controlled oxygenated rewarming machine perfusion - 1 hour | Lactate levels from bile after controlled oxygenated rewarming machine perfusion - 1 hour - in extended criteria donors livers. | 1 hour | 
| Pyruvate level in microdialysate from bile after controlled oxygenated rewarming machine perfusion - 1 hour | Pyruvate levels from bile after controlled oxygenated rewarming machine perfusion - 1 hour - in extended criteria donors livers. | 1 hour | 
| Pyruvate level in microdialysate from bile after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Pyruvate levels from bile after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours - in extended criteria donors livers. | 2 hours | 
| Glycerol level in microdialysate from bile after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Glycerol levels from bile after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours - in extended criteria donors livers. | 2 hours | 
| Lactate level in microdialysate from bile after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Lactate levels from bile after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours - in extended criteria donors livers. | 2 hours | 
| Glucose level in microdialysate from bile after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Glucose levels from bile after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours - in extended criteria donors livers. | 2 hours | 
| Bile gases pH - 4 hours after normothermic machine perfusion | Bile gas pH - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases pH - 2.5 hours after normothermic machine perfusion | Bile gas pH - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases Lactate - 4 hours after normothermic machine perfusion | Bile gas Lactate - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases Lactate - 2.5 hours after normothermic machine perfusion | Bile gas Lactate - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases Glucose - 4 hours after normothermic machine perfusion | Bile gas Glucose - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases Glucose - 2.5 hours after normothermic machine perfusion | Bile gas Glucose - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases Oxygen (O2) - 4 hours after normothermic machine perfusion | Bile gas O2 - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases O2 - 2.5 hours after normothermic machine perfusion | Bile gas O2 - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases carbon dioxide (CO2) - 4 hours after normothermic machine perfusion | Bile gas CO2 - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases CO2 - 2.5 hours after normothermic machine perfusion | Bile gas CO2 - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases bicarbonate (HCO3) - 4 hours after normothermic machine perfusion | Bile gas HCO3 - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases HCO3 - 2.5 hours after normothermic machine perfusion | Bile gas HCO3 - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases base excess (BE) - 4 hours after normothermic machine perfusion | Bile gas BE - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Ischemia/reperfusion injury - 4 hours after normothermic machine perfusion | Ischemia/reperfusion injury in liver biopsies, graded according to Ali JM et al, Liver transplant 2015; nil, mild, moderate, and severe. - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Ischemia/reperfusion damage - 4 hours after normothermic machine perfusion | Ischemia/reperfusion damage in liver biopsies, graded according to Suzuki score (Tian Y et al, Stem Cell Research & Therapy, 2016); score 0, 1, 2, 3, (0=none, 4= severe) - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Ischemia/reperfusion injury - after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Ischemia/reperfusion injury in liver biopsies, graded according to Tian Y et al et al, Liver transplant 2015; nil, mild, moderate, and severe. - after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 4 hours | 
| Ischemia/reperfusion damage - after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Ischemia/reperfusion damage in liver biopsies, graded according to Suzuki score (Tian Y et al, Stem Cell Research & Therapy, 2016); score 0, 1, 2, 3, (0=none, 4= severe) - after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 4 hours | 
| Ischemia/reperfusion injury - before machine perfusion | Ischemia/reperfusion injury in liver biopsies, graded according to Ali JM et al, Liver transplant 2015; nil, mild, moderate, and severe. - before machine perfusion in extended criteria donors livers | 1 minute | 
| Ischemia/reperfusion damage - before machine perfusion | Ischemia/reperfusion damage in liver biopsies, graded according to Suzuki score (Tian Y et al, Stem Cell Research & Therapy, 2016); score 0, 1, 2, 3, (0=none, 4= severe) - before machine perfusion in extended criteria donors livers | 1 minute | 
| Ischemia/reperfusion injury - after controlled oxygenated rewarming machine perfusion - 1 hour | Ischemia/reperfusion injury in liver biopsies, graded according to Ali JM et al, Liver transplant 2015; nil, mild, moderate, and severe - after controlled oxygenated rewarming machine perfusion - 1 hour in extended criteria donors livers | 1 hour | 
| Ischemia/reperfusion damage - after controlled oxygenated rewarming machine perfusion - 1 hour | Ischemia/reperfusion damage in liver biopsies, graded according to Suzuki score (Tian Y et al, Stem Cell Research & Therapy, 2016); score 0, 1, 2, 3, (0=none, 4= severe) - after controlled oxygenated rewarming machine perfusion - 1 hour in extended criteria donors livers | 1 hour | 
| Ischemia/reperfusion injury - 2.5 hours after normothermic machine perfusion | Ischemia/reperfusion injury in liver biopsies, graded according to Ali JM et al, Liver transplant 2015; nil, mild, moderate, and severe. - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Ischemia/reperfusion damage - 2.5 hours after normothermic machine perfusion | Ischemia/reperfusion damage in liver biopsies, graded according to Suzuki score (Tian Y et al, Stem Cell Research & Therapy, 2016); score 0, 1, 2, 3, (0=none, 4= severe) - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases BE - 2.5 hours after normothermic machine perfusion | Bile gas BE - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases oxygen saturation (SO2) - 4 hours after normothermic machine perfusion | Bile gas SO2- 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases SO2 - 2.5 hours after normothermic machine perfusion | Bile gas SO2- 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases hemoglobin (Hb)- 4 hours after normothermic machine perfusion | Bile gas Hb - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases Hb - 2.5 hours after normothermic machine perfusion | Bile gas Hb - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases sodium (Na) - 4 hours after normothermic machine perfusion | Bile gas Na - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases Na - 2.5 hours after normothermic machine perfusion | Bile gas Na - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases potassium (K) - 4 hours after normothermic machine perfusion | Bile gas K - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases K - 2.5 hours after normothermic machine perfusion | Bile gas K - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gases Calcium (Ca) - 4 hours after normothermic machine perfusion | Bile gas Ca - 4 hours after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Bile gases Ca - 2.5 hours after normothermic machine perfusion | Bile gas Ca - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Markers of injury, inflammation - 2.5 hours after normothermic machine perfusion | Markers of injury, inflammation - 2.5 hours after normothermic machine perfusion in extended criteria donors livers. | 2.5 hours | 
| Bile gas lactate 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas lactate 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Markers of injury, inflammation 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Markers of injury, inflammation 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas Glucose 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas Glucose 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas pH 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas pH 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas O2 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas O2 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas CO2 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas CO2 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas HCO3 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas HCO3 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas SO2 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas SO2 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas Hemoglobin 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas Hemoglobin 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas Na 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas Na 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas K 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas K 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas Ca 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas Ca 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Bile gas BE 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion | Bile gas BE 2 hours after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Markers of injury, inflammation 1 hour after controlled oxygenated rewarming machine perfusion | Markers of injury, inflammation 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Bile gas lactate 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas lactate 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas Glucose 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas Glucose 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas pH 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas pH 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Markers of injury, inflammation 1 hour after controlled oxygenated rewarming machine perfusion | Markers of injury, inflammation 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas O2 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas O2 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas CO2 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas CO2 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas HCO3 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas HCO3 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas BE 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas BE 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas SO2 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas SO2 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas hemoglobin 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas hemoglobin 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas Na 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas Na 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas K 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas K 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Bile gas Ca 1 hour after controlled oxygenated rewarming machine perfusion | Bile gas Ca 1 hour after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hours | 
| Perfusate gas Ca - during machine perfusion | Perfusate gas Ca during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas pH - during machine perfusion | Perfusate gas pH during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas SO2 - during machine perfusion | Perfusate gas SO2 during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas O2 - during machine perfusion | Perfusate gas O2 during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas CO2 - during machine perfusion | Perfusate gas CO2 during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas K - during machine perfusion | Perfusate gas K during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas Na - during machine perfusion | Perfusate gas Na during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas BE - during machine perfusion | Perfusate gas BE during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas HCO3 - during machine perfusion | Perfusate gas HCO3 during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas hemoglobin - during machine perfusion | Perfusate gas hemoglobin during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas lactate - during machine perfusion | Perfusate gas lactate during machine perfusion in extended criteria donors livers. | 24 hours | 
| Perfusate gas glucose - during machine perfusion | Perfusate gas glucose during machine perfusion in extended criteria donors livers. | 24 hours | 
| Postoperative complications | According to Clavien Dindo Classification | 12 months | 
| Length of stay | Length of initial ICU and initial hospital stay is determined in days of admission following liver transplantation. | 4 months | 
| Machine flow during controlled oxygenated rewarming | Machine flow (millilitre/hour) | 1 hour | 
| Machine flow during Dual-end-ischemic Hypothermic Oxygenated Perfusion | Machine flow (millilitre/hour) | 1 hour | 
| Machine pressure during controlled oxygenated rewarming | Machine pressure ((millimetre Hg)) | 1 hour | 
| Machine pressure during Dual-end-ischemic Hypothermic Oxygenated Perfusion | Machine pressure ((millimetre Hg)) | 1 hour | 
| Machine Fraction of oxygen during controlled oxygenated rewarming | Machine fraction of oxygen (%) | 1 hour | 
| Machine Fraction of oxygen Dual-end-ischemic Hypothermic Oxygenated Perfusion | Machine fraction of oxygen (%) | 1 hour | 
| Machine Resistance during controlled oxygenated rewarming | Machine Resistance (millilitre/minute/millimetre Hg) | 1 hour | 
| Machine Resistance during Dual-end-ischemic Hypothermic Oxygenated Perfusion | Machine Resistance (millilitre/minute/millimetre Hg) | 1 hour | 
| Machine flow during Dual-end-ischemic Hypothermic Oxygenated Perfusion | Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion flow (millilitre/hour) | 2 hours | 
| Machine flow during normothermic machine perfusion | Machine flow during normothermic machine perfusion (millilitre/hour) | 4 hours | 
| Machine flow during normothermic machine perfusion | Machine flow during normothermic machine perfusion (millilitre/hour) | 2.5 hours | 
| Machine pressure during normothermic machine perfusion | Machine pressure (millimetre Hg) | 4 hours | 
| Machine pressure during normothermic machine perfusion | Machine pressure (millimetre Hg) | 2.5 hours | 
| Machine Fraction of oxygen during normothermic machine perfusion | Machine fraction of oxygen (%) | 4 hours | 
| Machine Fraction of oxygen during normothermic machine perfusion | Machine fraction of oxygen (%) | 2.5 hours | 
| Machine Resistance during normothermic machine perfusion | Machine Resistance (millilitre/minute/millimetre Hg) | 4 hours | 
| Machine Resistance during normothermic machine perfusion | Machine Resistance (millilitre/minute/millimetre Hg) | 2.5 hours | 
| Total preservation time | Total preservation time (machine perfusion time) | 48 hours | 
| Alanine amino transferase in perfusate during machine perfusion | Alanine amino transferase in perfusate during machine perfusion (U/Litre) | 24 hours | 
| Aspartate amino transferase in perfusate during machine perfusion | Aspartate amino transferase in perfusate during machine perfusion (U/Litre) | 24 hours | 
| Alkaline phosphatase in perfusate during machine perfusion | Aspartate amino transferase in perfusate during machine perfusion (U/Litre) | 24 hours | 
| Gamma-glutamyl transferase in perfusate during machine perfusion | Gamma-glutamyl transferase in perfusate during machine perfusion (U/Litre) | 24 hours | 
| Urea in perfusate during machine perfusion | Urea in perfusate during machine perfusion (millimol/Litre) | 24 hours | 
| Bilirubin in perfusate during machine perfusion | Bilirubin in perfusate during machine perfusion (micromol/Litre) | 24 hours | 
| Not yet decided types of cytokines/interleukins, endothelium markers, miRNA's in perfusate during machine perfusion | Different cytokines/interleukins, endothelium markers, miRNA's in perfusate during machine perfusion | 24 hours | 
| Not yet decided types of cytokines/interleukins, endothelium markers, miRNA's in liver tissue during machine perfusion | Different cytokines/interleukins, endothelium markers, miRNA's in liver tissue during machine perfusion | 24 hours | 
| Not yet decided types of cytokines/interleukins, endothelium markers, miRNA's in bile during machine perfusion | Different cytokines/interleukins, endothelium markers, miRNA's in bile during machine perfusion | 24 hours | 
| Histopathology - liver tissue. Mitochondrial function | Histological analysis of parenchymal biopsies which are assessed for mitochondrial function. | During machine perfusion - 24 hours | 
| Histopathology - bile duct. Mitochondrial function | Histological analysis of bile duct biopsies which are assessed for mitochondrial function. | During machine perfusion - 24 hours | 
| Histopathology - liver tissue. Perfusion/reperfusion injury | Histological analysis of parenchymal biopsies which are assessed for perfusion/reperfusion injury | During machine perfusion - 24 hours | 
| Histopathology - bile duct. Perfusion/reperfusion injury | Histological analysis of bile duct biopsies which are assessed for perfusion/reperfusion injury | During machine perfusion - 24 hours | 
| Histopathology - liver tissue. Cell death | Histological analysis of parenchymal biopsies which are assessed for cell death | During machine perfusion - 24 hours | 
| Histopathology - bile duct. Cell death | Histological analysis of bile duct biopsies which are assessed for cell death | During machine perfusion - 24 hours | 
| Histopathology - liver tissue. Inflammation | Histological analysis of parenchymal biopsies which are assessed for inflammation | During machine perfusion - 24 hours | 
| Histopathology - bile duct. Inflammation | Histological analysis of bile duct biopsies which are assessed for inflammation | During machine perfusion - 24 hours | 
| Histopathology - liver tissue. Metabolomics | Histological analysis of parenchymal biopsies which are assessed for metabolomics | During machine perfusion - 24 hours | 
| Histopathology - bileduct. Metabolomics | Histological analysis of bile duct biopsies which are assessed for metabolomics | During machine perfusion - 24 hours | 
| Histopathology - liver tissue. Lipidomics | Histological analysis of parenchymal biopsies which are assessed for lipidomics | During machine perfusion - 24 hours | 
| Histopathology - bile duct. Lipidomics | Histological analysis of bile duct biopsies which are assessed for lipidomics | During machine perfusion - 24 hours | 
| Histopathology - liver tissue. RNA sequencing | Histological analysis of parenchymal biopsies which are assessed for RNA sequencing | During machine perfusion - 24 hours | 
| Histopathology - bile duct. RNA sequencing | Histological analysis of bile duct biopsies which are assessed for RNA sequencing | During machine perfusion - 24 hours | 
| Histopathology - liver tissue. Endothelium properties | Histological analysis of parenchymal biopsies which are assessed for endothelium properties | During machine perfusion - 24 hours | 
| Histopathology - bile duct. Endothelium properties | Histological analysis of bile duct biopsies which are assessed for endothelium properties | During machine perfusion - 24 hours | 
| International normalized ratio on postoperative day 7 | Blood sample from recipient: International normalized ratio on postoperative day 7 | 7 postoperative day | 
| Alanine amino transferase postoperative day 0 | Alanine amino transferase postoperative day 0 in the donated recipients (U/Litre) | Postoperative day 0 | 
| Aspartate amino transferase postoperative day 0 | Aspartate amino transferase postoperative day 0 in the donated recipients (U/Litre) | Postoperative day 0 | 
| Alkaline phosphatase postoperative day 0 | Alkaline phosphatase postoperative day 0 in the donated recipients (U/Litre) | Postoperative day 0 | 
| Gamma-glutamyl transferase postoperative day 0 | Gamma-glutamyl transferase postoperative day 0 in the donated recipients (U/Litre) | Postoperative day 0 | 
| Urea postoperative day 0 | Urea postoperative day 0 in the donated recipients (millimol/Litre) | Postoperative day 0 | 
| Bilirubin postoperative day 0 | Bilirubin postoperative day 0 in the donated recipients (micromol/Litre) | Postoperative day 0 | 
| Bilirubin postoperative day 1 | Bilirubin postoperative day 1 in the donated recipients (micromol/Litre) | Postoperative day 1 | 
| Bilirubin postoperative day 2 | Bilirubin postoperative day 2 in the donated recipients (micromol/Litre) | Postoperative day 2 | 
| Bilirubin postoperative day 3 | Bilirubin postoperative day 3 in the donated recipients (micromol/Litre) | Postoperative day 3 | 
| Bilirubin postoperative day 4 | Bilirubin postoperative day 4 in the donated recipients (micromol/Litre) | Postoperative day 4 | 
| Bilirubin postoperative day 5 | Bilirubin postoperative day 5 in the donated recipients (micromol/Litre) | Postoperative day 5 | 
| Bilirubin postoperative day 6 | Bilirubin postoperative day 6 in the donated recipients (micromol/Litre) | Postoperative day 6 | 
| Bilirubin postoperative day 7 | Bilirubin postoperative day 7 in the donated recipients (micromol/Litre) | Postoperative day 7 | 
| Urea postoperative day 1 | Urea postoperative day 1 in the donated recipients (millimol/Litre) | Postoperative day 1 | 
| Urea postoperative day 2 | Urea postoperative day 2 in the donated recipients (millimol/Litre) | Postoperative day 2 | 
| Urea postoperative day 3 | Urea postoperative day 3 in the donated recipients (millimol/Litre) | Postoperative day 3 | 
| Urea postoperative day 4 | Urea postoperative day 4 in the donated recipients (millimol/Litre) | Postoperative day 4 | 
| Urea postoperative day 5 | Urea postoperative day 5 in the donated recipients (millimol/Litre) | Postoperative day 5 | 
| Urea postoperative day 6 | Urea postoperative day 6 in the donated recipients (millimol/Litre) | Postoperative day 6 | 
| Urea postoperative day 7 | Urea postoperative day 7 in the donated recipients (millimol/Litre) | Postoperative day 7 | 
| Aspartate amino transferase postoperative day 1 | Aspartate amino transferase postoperative day 1 in the donated recipients (U/Litre) | Postoperative day 1 | 
| Alkaline phosphatase postoperative day 1 | Alkaline phosphatase postoperative day 1 in the donated recipients (U/Litre) | Postoperative day 1 | 
| Gamma-glutamyl transferase postoperative day 1 | Gamma-glutamyl transferase postoperative day 1 in the donated recipients (U/Litre) | Postoperative day 1 | 
| Alanine amino transferase postoperative day 2 | Alanine amino transferase postoperative day 2 in the donated recipients (U/Litre) | Postoperative day 2 | 
| Aspartate amino transferase postoperative day 2 | Aspartate amino transferase postoperative day 2 in the donated recipients (U/Litre) | Postoperative day 2 | 
| Alkaline phosphatase postoperative day 2 | Alkaline phosphatase postoperative day 2 in the donated recipients (U/Litre) | Postoperative day 2 | 
| Gamma-glutamyl transferase postoperative day 2 | Gamma-glutamyl transferase postoperative day 2 in the donated recipients (U/Litre) | Postoperative day 2 | 
| Alanine amino transferase postoperative day 3 | Alanine amino transferase postoperative day 3 in the donated recipients (U/Litre) | Postoperative day 3 | 
| Aspartate amino transferase postoperative day 3 | Aspartate amino transferase postoperative day 3 in the donated recipients (U/Litre) | Postoperative day 3 | 
| Alkaline phosphatase postoperative day 3 | Alkaline phosphatase postoperative day 3 in the donated recipients (U/Litre) | Postoperative day 3 | 
| Gamma-glutamyl transferase postoperative day 3 | Gamma-glutamyl transferase postoperative day 3 in the donated recipients (U/Litre) | Postoperative day 3 | 
| Alanine amino transferase postoperative day 4 | Alanine amino transferase postoperative day 4 in the donated recipients (U/Litre) | Postoperative day 4 | 
| Aspartate amino transferase postoperative day 4 | Aspartate amino transferase postoperative day 4 in the donated recipients (U/Litre) | Postoperative day 4 | 
| Alkaline phosphatase postoperative day 4 | Alkaline phosphatase postoperative day 4 in the donated recipients (U/Litre) | Postoperative day 4 | 
| Gamma-glutamyl transferase postoperative day 4 | Gamma-glutamyl transferase postoperative day 4 in the donated recipients (U/Litre) | Postoperative day 4 | 
| Alanine amino transferase postoperative day 5 | Alanine amino transferase postoperative day 5 in the donated recipients (U/Litre) | Postoperative day 5 | 
| Aspartate amino transferase postoperative day 5 | Aspartate amino transferase postoperative day 5 in the donated recipients (U/Litre) | Postoperative day 5 | 
| Alkaline phosphatase postoperative day 5 | Alkaline phosphatase postoperative day 5 in the donated recipients (U/Litre) | Postoperative day 5 | 
| Gamma-glutamyl transferase postoperative day 5 | Gamma-glutamyl transferase postoperative day 5 in the donated recipients (U/Litre) | Postoperative day 5 | 
| Alanine amino transferase postoperative day 6 | Alanine amino transferase postoperative day 6 in the donated recipients (U/Litre) | Postoperative day 6 | 
| Aspartate amino transferase postoperative day 6 | Aspartate amino transferase postoperative day 6 in the donated recipients (U/Litre) | Postoperative day 6 | 
| Alkaline phosphatase postoperative day 6 | Aspartate amino transferase postoperative day 6 in the donated recipients (U/Litre) | Postoperative day 6 | 
| Gamma-glutamyl transferase postoperative day 6 | Gamma-glutamyl transferase postoperative day 6 in the donated recipients (U/Litre) | Postoperative day 6 | 
| Alanine amino transferase postoperative day 7 | Alanine amino transferase postoperative day 7 in the donated recipients (U/Litre) | Postoperative day 7 | 
| Aspartate amino transferase postoperative day 7 | Aspartate amino transferase postoperative day 7 in the donated recipients (U/Litre) | Postoperative day 7 | 
| Alkaline phosphatase postoperative day 7 | Alkaline phosphatase postoperative day 7 in the donated recipients (U/Litre) | Postoperative day 7 | 
| Gamma-glutamyl transferase postoperative day 7 | Gamma-glutamyl transferase postoperative day 7 in the donated recipients (U/Litre) | Postoperative day 7 | 
| Alanine amino transferase postoperative month 1 | Alanine amino transferase postoperative month 1 in the donated recipients (U/Litre) | 1 month after surgery | 
| Aspartate amino transferase postoperative month 1 | Aspartate amino transferase postoperative month 1 in the donated recipients (U/Litre) | 1 month after surgery | 
| Alkaline phosphatase postoperative month 1 | Alkaline phosphatase postoperative month 1 in the donated recipients (U/Litre) | 1 month after surgery | 
| Gamma-glutamyl transferase postoperative month 1 | Gamma-glutamyl transferase postoperative month 1 in the donated recipients (U/Litre) | 1 month after surgery | 
| Urea postoperative month 1 | Urea postoperative month 1 in the donated recipients (millimol/Litre) | 1 month after surgery | 
| Bilirubin postoperative month 1 | Bilirubin postoperative month 1 in the donated recipients (micromol/Litre) | 1 month after surgery | 
| Bilirubin postoperative month 2 | Bilirubin postoperative month 2 in the donated recipients (micromol/Litre) | 2 month after surgery | 
| Bilirubin postoperative month 3 | Bilirubin postoperative month 3 in the donated recipients (micromol/Litre) | 3 month after surgery | 
| Bilirubin postoperative month 4 | Bilirubin postoperative month 4 in the donated recipients (micromol/Litre) | 4 month after surgery | 
| Bilirubin postoperative month 5 | Bilirubin postoperative month 5 in the donated recipients (micromol/Litre) | 5 month after surgery | 
| Bilirubin postoperative month 6 | Bilirubin postoperative month 6 in the donated recipients (micromol/Litre) | 6 month after surgery | 
| Bilirubin postoperative month 7 | Bilirubin postoperative month 7 in the donated recipients (micromol/Litre) | 7 month after surgery | 
| Bilirubin postoperative month 8 | Bilirubin postoperative month 8 in the donated recipients (micromol/Litre) | 8 month after surgery | 
| Bilirubin postoperative month 9 | Bilirubin postoperative month 9 in the donated recipients (micromol/Litre) | 9 month after surgery | 
| Bilirubin postoperative month 10 | Bilirubin postoperative month 10 in the donated recipients (micromol/Litre) | 10 month after surgery | 
| Bilirubin postoperative month 11 | Bilirubin postoperative month 11 in the donated recipients (micromol/Litre) | 11 month after surgery | 
| Bilirubin postoperative month 12 | Bilirubin postoperative month 12 in the donated recipients (micromol/Litre) | 12 month after surgery | 
| Urea postoperative month 2 | Urea postoperative month 2 in the donated recipients (millimol/Litre) | 2 month after surgery | 
| Urea postoperative month 3 | Urea postoperative month 3 in the donated recipients (millimol/Litre) | 3 month after surgery | 
| Urea postoperative month 4 | Urea postoperative month 4 in the donated recipients (millimol/Litre) | 4 month after surgery | 
| Urea postoperative month 5 | Urea postoperative month 5 in the donated recipients (millimol/Litre) | 5 month after surgery | 
| Urea postoperative month 6 | Urea postoperative month 6 in the donated recipients (millimol/Litre) | 6 month after surgery | 
| Urea postoperative month 7 | Urea postoperative month 7 in the donated recipients (millimol/Litre) | 7 month after surgery | 
| Urea postoperative month 8 | Urea postoperative month 8 in the donated recipients (millimol/Litre) | 8 month after surgery | 
| Urea postoperative month 9 | Urea postoperative month 9 in the donated recipients (millimol/Litre) | 9 month after surgery | 
| Urea postoperative month 10 | Urea postoperative month 10 in the donated recipients (millimol/Litre) | 10 month after surgery | 
| Urea postoperative month 11 | Urea postoperative month 11 in the donated recipients (millimol/Litre) | 11 month after surgery | 
| Urea postoperative month 12 | Urea postoperative month 12 in the donated recipients (millimol/Litre) | 12 month after surgery | 
| Alanine amino transferase postoperative month 2 | Alanine amino transferase postoperative month 2 in the donated recipients (U/Litre) | 2 month after surgery | 
| Aspartate amino transferase postoperative month 2 | Aspartate amino transferase postoperative month 2 in the donated recipients (U/Litre) | 2 month after surgery | 
| Alkaline phosphatase postoperative month 2 | Alkaline phosphatase postoperative month 2 in the donated recipients (U/Litre) | 2 month after surgery | 
| Gamma-glutamyl transferase postoperative month 2 | Gamma-glutamyl transferase postoperative month 2 in the donated recipients (U/Litre) | 2 month after surgery | 
| Alanine amino transferase postoperative month 3 | Alanine amino transferase postoperative month 3 in the donated recipients (U/Litre) | 3 month after surgery | 
| Aspartate amino transferase postoperative month 3 | Aspartate amino transferase postoperative month 3 in the donated recipients (U/Litre) | 3 month after surgery | 
| Alkaline phosphatase postoperative month 3 | Alkaline phosphatase postoperative month 3 in the donated recipients (U/Litre) | 3 month after surgery | 
| Gamma-glutamyl transferase postoperative month 3 | Gamma-glutamyl transferase postoperative month 3 in the donated recipients (U/Litre) | 3 month after surgery | 
| Alanine amino transferase postoperative month 4 | Alanine amino transferase postoperative month 4 in the donated recipients (U/Litre) | 4 month after surgery | 
| Aspartate amino transferase postoperative month 4 | Aspartate amino transferase postoperative month 4 in the donated recipients (U/Litre) | 4 month after surgery | 
| Alkaline phosphatase postoperative month 4 | Alkaline phosphatase postoperative month 4 in the donated recipients (U/Litre) | 4 month after surgery | 
| Gamma-glutamyl transferase postoperative month 4 | Gamma-glutamyl transferase postoperative month 4 in the donated recipients (U/Litre) | 4 month after surgery | 
| Alanine amino transferase postoperative month 5 | Alanine amino transferase postoperative month 5 in the donated recipients (U/Litre) | 5 month after surgery | 
| Aspartate amino transferase postoperative month 5 | Aspartate amino transferase postoperative month 5 in the donated recipients (U/Litre) | 5 month after surgery | 
| Alkaline phosphatase postoperative month 5 | Alkaline phosphatase postoperative month 5 in the donated recipients (U/Litre) | 5 month after surgery | 
| Gamma-glutamyl transferase postoperative month 5 | Gamma-glutamyl transferase postoperative month 5 in the donated recipients (U/Litre) | 5 month after surgery | 
| Alanine amino transferase postoperative month 6 | Alanine amino transferase postoperative month 6 in the donated recipients (U/Litre) | 6 month after surgery | 
| Aspartate amino transferase postoperative month 6 | Aspartate amino transferase postoperative month 6 in the donated recipients (U/Litre) | 6 month after surgery | 
| Alkaline phosphatase postoperative month 6 | Alkaline phosphatase postoperative month 6 in the donated recipients (U/Litre) | 6 month after surgery | 
| Gamma-glutamyl transferase postoperative month 6 | Gamma-glutamyl transferase postoperative month 6 in the donated recipients (U/Litre) | 6 month after surgery | 
| Alanine amino transferase postoperative month 7 | Alanine amino transferase postoperative month 7 in the donated recipients (U/Litre) | 7 month after surgery | 
| Aspartate amino transferase postoperative month 7 | Aspartate amino transferase postoperative month 7 in the donated recipients (U/Litre) | 7 month after surgery | 
| Alkaline phosphatase postoperative month 7 | Alkaline phosphatase postoperative month 7 in the donated recipients (U/Litre) | 7 month after surgery | 
| Gamma-glutamyl transferase postoperative month 7 | Gamma-glutamyl transferase postoperative month 7 in the donated recipients (U/Litre) | 7 month after surgery | 
| Alanine amino transferase postoperative month 8 | Alanine amino transferase postoperative month 8 in the donated recipients (U/Litre) | 8 month after surgery | 
| Aspartate amino transferase postoperative month 8 | Aspartate amino transferase postoperative month 8 in the donated recipients (U/Litre) | 8 month after surgery | 
| Alkaline phosphatase postoperative month 8 | Alkaline phosphatase postoperative month 8 in the donated recipients (U/Litre) | 8 month after surgery | 
| Gamma-glutamyl transferase postoperative month 8 | Gamma-glutamyl transferase postoperative month 8 in the donated recipients (U/Litre) | 8 month after surgery | 
| Alanine amino transferase postoperative month 9 | Alanine amino transferase postoperative month 9 in the donated recipients (U/Litre) | 9 month after surgery | 
| Aspartate amino transferase postoperative month 9 | Aspartate amino transferase postoperative month 9 in the donated recipients (U/Litre) | 9 month after surgery | 
| Alkaline phosphatase postoperative month 9 | Alkaline phosphatase postoperative month 9 in the donated recipients (U/Litre) | 9 month after surgery | 
| Gamma-glutamyl transferase postoperative month 9 | Gamma-glutamyl transferase postoperative month 9 in the donated recipients (U/Litre) | 9 month after surgery | 
| Alanine amino transferase postoperative month 10 | Alanine amino transferase postoperative month 10 in the donated recipients (U/Litre) | 10 month after surgery | 
| Aspartate amino transferase postoperative month 10 | Aspartate amino transferase postoperative month 10 in the donated recipients (U/Litre) | 10 month after surgery | 
| Alkaline phosphatase postoperative month 10 | Alkaline phosphatase postoperative month 10 in the donated recipients (U/Litre) | 10 month after surgery | 
| Gamma-glutamyl transferase postoperative month 10 | Gamma-glutamyl transferase postoperative month 10 in the donated recipients (U/Litre) | 10 month after surgery | 
| Alanine amino transferase postoperative month 11 | Alanine amino transferase postoperative month 11 in the donated recipients (U/Litre) | 11 month after surgery | 
| Aspartate amino transferase postoperative month 11 | Aspartate amino transferase postoperative month 11 in the donated recipients (U/Litre) | 11 month after surgery | 
| Alkaline phosphatase postoperative month 11 | Alkaline phosphatase postoperative month 11 in the donated recipients (U/Litre) | 11 month after surgery | 
| Gamma-glutamyl transferase postoperative month 11 | Gamma-glutamyl transferase postoperative month 11 in the donated recipients (U/Litre) | 11 month after surgery | 
| Alanine amino transferase postoperative month 12 | Alanine amino transferase postoperative month 12 in the donated recipients (U/Litre) | 12 month after surgery | 
| Aspartate amino transferase postoperative month 12 | Aspartate amino transferase postoperative month 12 in the donated recipients (U/Litre) | 12 month after surgery | 
| Alkaline phosphatase postoperative month 12 | Alkaline phosphatase postoperative month 12 in the donated recipients (U/Litre) | 12 month after surgery | 
| Gamma-glutamyl transferase postoperative month 12 | Gamma-glutamyl transferase postoperative month 12 in the donated recipients (U/Litre) | 12 month after surgery | 
| Postoperative microdialysis levels of lactate | Postoperative microdialysis levels of lactate in transplanted livers the first 14 postoperative days | 14 days | 
| Postoperative microdialysis levels of pyruvate | Postoperative microdialysis levels of pyruvate in transplanted livers the first 14 postoperative days | 14 days | 
| Postoperative microdialysis levels of glycerol | Postoperative microdialysis levels of glycerol in transplanted livers the first 14 postoperative days | 14 days | 
| Postoperative microdialysis levels of glucose | Postoperative microdialysis levels of glucose in transplanted livers the first 14 postoperative days | 14 days | 
| Systolic blood pressure | Systolic blood pressure (millimeter Hg) | From 5 min before reperfusion, up to 20 minutes after reperfusion | 
| Diastolic blood pressure | Diastolic blood pressure (millimeter Hg) | From 5 min before reperfusion, up to 20 minutes after reperfusion | 
| Heart rate | Heart rate (Beats/minute) | From 5 min before reperfusion, up to 20 minutes after reperfusion | 
| Vasopressor dosage | Vasopressor dosage (microgram/kilogram/minutes) | From 5 min before reperfusion, up to 20 minutes after reperfusion | 
| Patient survival | Patient survival (days) | Through study completion, an average of 12 months | 
| Graft survival | Graft (censored and uncensored for patient death) survival (days) | Through study completion, an average of 12 months | 
| Number of deaths | Number of deaths first 7 days after transplantation | 7 days after transplantation | 
| Number of retransplantation | Number of retransplantation first 7 days after transplantation | 7 days after transplantation | 
| Incidens of new onset diabetes after transplantation | New onset diabetes after transplantation after transplantation. New onset diabetes after transplantation is defined according to the World Health Organization criteria (Report 2003 S5-20). | Through study completion, an average of 12 months | 
| Estimated glomerular filtration rate - Renal function | Estimated glomerular filtration rate according to the 4-variable Modification of Diet in Renal Disease equation. | Through study completion, an average of 12 months | 
| The incidence of symptomatic Non-anastomotic Biliary Strictures | The incidence of symptomatic non-anastomotic biliary strictures | 6 months | 
| The incidence of asymptomatic Non-anastomotic Biliary Strictures | The incidence of asymptomatic non-anastomotic biliary strictures | 6 months | 
| The incidence of asymptomatic Non-anastomotic Biliary Strictures | The incidence of asymptomatic non-anastomotic biliary strictures | 12 months | 
| The incidence of symptomatic Non-anastomotic Biliary Strictures | The incidence of symptomatic non-anastomotic biliary strictures | 12 months | 
| The severity of Non-anastomotic Biliary Strictures | The severity of Non-anastomotic Biliary Strictures based on a scoring system described by Buis et. al (mild, moderate, or severe) | Through study completion, an average of 12 months | 
| The location of Non-anastomotic Biliary Strictures | The location of Non-anastomotic Biliary Strictures is assessed by images of the magnetic resonance cholangiopancreatography | Through study completion, an average of 12 months | 
| The incidence of infections | The incidence of infections leading to administration of antibiotics/antifungal/antiviral treatment | Through study completion, an average of 12 months | 
| Lactate level in microdialysate from liver tissue - 4 hours | Microdialysis lactate level in donor liver tissue after 4 hours of normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Pyruvate level in microdialysate from hilar plate after normothermic machine perfusion - 4 hours | Pyruvate level in microdialysate from hilar plate after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Glycerol level in microdialysate from hilar plate after normothermic machine perfusion - 4 hours | Glycerol level in microdialysate from hilar plate after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Glucose level in microdialysate from hilar plate after normothermic machine perfusion - 4 hours | Glucose level in microdialysate from hilar plate after normothermic machine perfusion in extended criteria donors livers. | 4 hours | 
| Glycerol level in microdialysate from hilar plate after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Glycerol level in microdialysate from hilar plate after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Lactate level in microdialysate from hilar plate after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion - 2 hours | Lactate level in microdialysate from hilar plate after Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hours | 
| Glucose level in microdialysate from hilar plate after controlled oxygenated rewarming machine perfusion - 1 hour | Glucose level in microdialysate from hilar plate after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Pyruvate level in microdialysate from hilar plate after controlled oxygenated rewarming machine perfusion - 1 hour | Pyruvate level in microdialysate from hilar plate after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Glycerol level in microdialysate from hilar plate after controlled oxygenated rewarming machine perfusion - 1 hour | Glycerol level in microdialysate from hilar plate after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Lactate level in microdialysate from hilar plate after controlled oxygenated rewarming machine perfusion - 1 hour | Lactate level in microdialysate from hilar plate after controlled oxygenated rewarming machine perfusion in extended criteria donors livers. | 1 hour | 
| Glucose level in microdialysate from hilar plate after of Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers - 2 hours | Glucose level in microdialysate from hilar plate after of Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hour | 
| Pyruvate level in microdialysate from hilar plate after of Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers - 2 hours | Pyruvate level in microdialysate from hilar plate after of Dual-end-ischemic Hypothermic Oxygenated Perfusion machine perfusion in extended criteria donors livers. | 2 hour | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
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Normothermic Machine Perfusion, Controlled Oxygenated Rewarming, Liver, Transplantation, Perfusion, Dual-end-ischemic Hypothermic Oxygenated Perfusion, Microdialysis