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EPI-STORM: Cytokine Storm in Organ Donors

Liver Transplantation | Kidney Transplantation | Organ Donation | Graft Dysfunction

Kidney and liver transplantation are the treatment of choice and are often the last therapeutic option offered to patients with chronic renal and liver failure. More than 70% of kidneys and liver available for transplantation are obtained from donors following neurological death. Unfortunately, compared to living donation, transplant function, graft survival, and recipient survival are consistently inferior with kidneys and liver from neurologically deceased donors. This difference lies with the exacerbated pro-inflammatory state characteristic of deceased donors. Indeed, when neurologic death occurs, the immune system releases substances in the blood that could harm organs and particularly the liver and the kidneys. We believe that achieving a better understanding of the inflammatory processes of organ donors could be greatly informative to design future randomized controlled trial assessing the effect of personalized immunosuppressive therapy on organ donors to ultimately improve the care provided to donors so as to increase the number of organs available for transplantation and enhancing the survival of received grafts

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Conditions de participation

  • Sexe:

    ALL

  • Âges admissibles:

    18 to 80

Critères de participation

Phase 1 of the study:

Inclusion Criteria:

* Patient admitted to the intensive care unit with a serious neurologic lesion
* Glasgow Coma Scale score ≤ 4
* Absence of sedation for the last 6 hours
* Age ≥ 18 years old

Exclusion Criteria:

* S. aureus bacteremia
* Active neoplasia
* Receiving immunosuppressive therapy (including steroids) for \> 3 months

Specific to potential liver donors:

* Hepatic insufficiency defined as i) INR \> 1.5, ii) hepatic encephalopathy, iii) AST, ALT \> 2 times normal value

Specific to potential kidney donors:

* Polycystic kidney disease
* Chronic renal failure (i.e., eGFR \< 60 ml/min)

Phase 2 of the study:

Inclusion Criteria:

* Organ donor after neurologic death (DND) declaration as determined by the attending physician
* Consent to organ donation obtained

Lieu de l'étude

Centre Hospitalier Universitaire de Montréal
Centre Hospitalier Universitaire de Montréal
Montréal, Quebec
Canada

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Hôpital Maisonneuve-Rosemont
Hôpital Maisonneuve-Rosemont
Montréal, Quebec
Canada

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Centre Hospitalier Universitaire de Québec- Université Laval
Centre Hospitalier Universitaire de Québec- Université Laval
Quebec city, Quebec
Canada

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CIUSSS de l'Estrie-CHUS
CIUSSS de l'Estrie-CHUS
Sherbrooke, Quebec
Canada

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Backup Contact

Daphnée Lamarche, PhD

[email protected]
819-821-8000
Primary Contact

Marie-Hélène Masse, RRT, MSc

[email protected]
819-346-1110
Étude parrainée par
Université de Sherbrooke
Participants recherchés
Plus d'informations
ID de l'étude: NCT03786991