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Trial registered on ANZCTR
Registration number
ACTRN12623000301662p
Ethics application status
Not yet submitted
Date submitted
8/03/2023
Date registered
17/03/2023
Date last updated
17/03/2023
Date data sharing statement initially provided
17/03/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Marine oxygen carrier (M101) for organ preservation in liver transplantation; a randomised exploratory study.
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Scientific title
The effect of marine oxygen carrier (M101) during cold static storage on the incidence of ischaemia reperfusion injury in liver transplantation; a randomised exploratory study.
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Secondary ID [1]
309062
0
Nil known
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Universal Trial Number (UTN)
U1111-1288-7725
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Liver Transplantation
329122
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Condition category
Condition code
Surgery
326094
326094
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0
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Other surgery
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Oral and Gastrointestinal
326095
326095
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
We will assess outcome after liver transplantation using grafts from deceased donors after brain death that have been perfused with University of Wisconsin solution (UWS) plus the oxygen carrier molecule M101 (HemO2life, Morlaix, France). M101 will be added to UWS that is flushed through the graft on a side table prior to cold static storage. All other donor and transplant procedures and post-transplant care will be standard in accordance with New Zealand Liver Transplant Unit protocol.
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Intervention code [1]
325504
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Treatment: Devices
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Comparator / control treatment
The control patients will receive a deceased donor liver graft from a brain dead donor that has been flushed on the side table with UWS, without the addition of M101.
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Control group
Active
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Outcomes
Primary outcome [1]
333975
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Assessment of early allograft function according to the L-GrAFT7 score (derived from day 1-7 AST, INR, bilirubin and platelet count blood tests).
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Assessment method [1]
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Timepoint [1]
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Day 7 post-transplant
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Secondary outcome [1]
418900
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Reperfusion syndrome, assessed according to Aggarwal criteria, from the anaesthesia record.
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Assessment method [1]
418900
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Timepoint [1]
418900
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Intra-operative, at time of graft reperfusion.
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Secondary outcome [2]
418901
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Histological assessment of ischaemia reperfusion injury on post-reperfusion liver biopsy.
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Assessment method [2]
418901
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Timepoint [2]
418901
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Graft biopsy prior to abdominal closure
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Secondary outcome [3]
418902
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Acute kidney injury according to Kidney Disease Improving Global Outcomes definition, assessed by serum creatinine levels.
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Assessment method [3]
418902
0
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Timepoint [3]
418902
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Daily blood tests post-operative day 1-7.
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Secondary outcome [4]
418903
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Biliary complications (leak, anastomotic or non-anastomic stricture) defined by cholangiography (MRC, ERCP or PTC) in combination with clinical symptoms and/or elevation of cholestatic liver tests.
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Assessment method [4]
418903
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Timepoint [4]
418903
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Post-operative, within 1 year of transplant.
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Secondary outcome [5]
418904
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Vascular complications; stenosis or thrombosis diagnosed on Doppler ultrasound, CT or MRI or at re-exploration.
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Assessment method [5]
418904
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Timepoint [5]
418904
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Post-operative, within 1 year of post transplant.
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Secondary outcome [6]
418905
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Complications according to Dindo-Clavien Classification, plus Comprehensive Complication Index (for example, post-operative pneumonia Grade II, re-operation for bleeding is Grade IIIb).
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Assessment method [6]
418905
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Timepoint [6]
418905
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Post-operative, within 30 days.
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Secondary outcome [7]
418906
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Acute cellular rejection, proven on liver graft biopsy.
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Assessment method [7]
418906
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Timepoint [7]
418906
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Post-operative, within 1 year of transplant.
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Secondary outcome [8]
418907
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Graft survival, assessed by data-linkage to medical records.
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Assessment method [8]
418907
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Timepoint [8]
418907
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1 year after transplant
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Secondary outcome [9]
418908
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Patient survival, assessed by data-linkage to medical records.
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Assessment method [9]
418908
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Timepoint [9]
418908
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1 year after transplant
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Secondary outcome [10]
419526
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Assays of mitochondrial function and oxidate stress on graft biopsies.
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Assessment method [10]
419526
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Timepoint [10]
419526
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End-ischaemic graft biopsy, and post-reperfusion graft biopsy.
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Secondary outcome [11]
419528
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Cellular immunity assay (iNKT cells, NK cells, myeloid cells, conventional T cells, TReg cells) by flow cytometry of blood samples.
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Assessment method [11]
419528
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Timepoint [11]
419528
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During transplant surgery (pre and post implantation), day 3 and day 7 post-operative.
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Secondary outcome [12]
419531
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Cytokine assays on blood samples (IL-33, HMGB-1, IL-6, IL-2, IL-18, sST2, amphiregulin, meteorin).
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Assessment method [12]
419531
0
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Timepoint [12]
419531
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During transplant surgery (pre and post implantation), day 3 and day 7 post-operative.
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Eligibility
Key inclusion criteria
Standard criteria graft from brain death deceased donor
Adult recipient of first liver transplant
Able to give informed consent
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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
Donation after circulatory death or extended criteria graft
Re-transplantation
Acute liver failure
Split liver transplant
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using computerised 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
Safety/efficacy
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Statistical methods / analysis
This is an exploratory or pilot study in liver transplantation, hence there is no sample size calculation. The primary outcome is a continuous variable and will be compared between intervention and control groups using unpaired Student t-test.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2023
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Actual
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Date of last participant enrolment
Anticipated
1/08/2024
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Actual
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Date of last data collection
Anticipated
1/08/2025
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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 outside Australia
Country [1]
25287
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New Zealand
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State/province [1]
25287
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Funding & Sponsors
Funding source category [1]
313267
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Self funded/Unfunded
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Name [1]
313267
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Address [1]
313267
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Country [1]
313267
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Primary sponsor type
Individual
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Name
A/Prof Louise Barbier
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Address
New Zealand Liver Transplant Unit
Te Toka Tumai - Auckland
2 Park Avenue
Grafton
Auckland 1023
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Country
New Zealand
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Secondary sponsor category [1]
315002
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Individual
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Name [1]
315002
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Prof John McCall
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Address [1]
315002
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New Zealand Liver Transplant Unit
Te Toka Tumai - Auckland
2 Park Avenue
Grafton
Auckland 1023
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Country [1]
315002
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New Zealand
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
312497
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Northern B Health and Disability Ethics Committee
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Ethics committee address [1]
312497
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
312497
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New Zealand
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Date submitted for ethics approval [1]
312497
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31/03/2023
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Approval date [1]
312497
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Ethics approval number [1]
312497
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Summary
Brief summary
Liver transplantation requires the donor liver to be stored for the period of time between being removed from the donor and transplanted into a recipient. This storage period can be up to 12 hours and during this time the liver does not receive any oxygen. Even though the liver is stored on ice, the lack of oxygen can result in injury to the liver cells and impair recovery after the transplant. M101 is a recently discovered oxygen carrying molecule with properties that make it very well suited for organ preservation. M101 will be added to the preservation fluid to provide oxygen during the period of storage, in order to prevent injury to liver cells from lack of oxygen. Studies in kidney transplantation found M101 to be safe and have a beneficial effect on kidney recovery after transplantation. M101 has also shown promising results in animal models of liver transplantation. However, it has not yet been tested in human liver transplantation. We would like to test whether adding M101 to the preservation fluid during storage of the donor liver improves liver function and patient recovery after the transplant. We will also assess whether M101 improves mitochondrial function (mitochondria are inside the liver cells and convert oxygen into the energy that the cells need to function) and modifies the immune response (which is activated by cell damage due to lack of oxygen). We hope that this research will lead to ways to improve the preservation of liver grafts used for transplantation, and that this will lead to better outcomes for patients.
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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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A/Prof Louise Barbier
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Address
124874
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New Zealand Liver Transplant Unit
Te Toka Tumai - Auckland
2 Park Avenue
Grafton
Auckland 1023
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Country
124874
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New Zealand
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Phone
124874
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+64 21395937
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Fax
124874
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Email
124874
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[email protected]
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Contact person for public queries
Name
124875
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Louise Barbier
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Address
124875
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New Zealand Liver Transplant Unit
Te Toka Tumai - Auckland
2 Park Avenue
Grafton
Auckland 1023
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Country
124875
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New Zealand
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Phone
124875
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+64 21395937
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Fax
124875
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Email
124875
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[email protected]
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Contact person for scientific queries
Name
124876
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Louise Barbier
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Address
124876
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New Zealand Liver Transplant Unit
Te Toka Tumai - Auckland
2 Park Avenue
Grafton
Auckland 1023
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Country
124876
0
New Zealand
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Phone
124876
0
+64 21395937
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Fax
124876
0
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Email
124876
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
This is a small trial in a distinct patient population and despite de-identification there is a risk that IPD could lead to inadvertent identification of individual participants.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
18427
Study protocol
[email protected]
18428
Informed consent form
[email protected]
18429
Statistical analysis plan
[email protected]
18430
Clinical study report
[email protected]
18431
Ethical approval
[email protected]
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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