BMJ Open (Mar 2022)

Impact of targeted hypothermia in expanded-criteria organ donors on recipient kidney-graft function: study protocol for a multicentre randomised controlled trial (HYPOREME)

  • Thomas Kerforne,
  • Christiane Mousson,
  • Karim Asehnoune,
  • Fanny Feuillet,
  • Olivier Huet,
  • Bertrand Rozec,
  • Aude Garin,
  • Alexandre Hertig,
  • Jeremy Bourenne,
  • Nassim Kamar,
  • Emmanuel Morelon,
  • Denis Glotz,
  • Morgane Péré,
  • Thierry Boulain,
  • Jean Reignier,
  • René Robert,
  • Dominique Bertrand,
  • Pierre-Yves Egreteau,
  • Thierry Benard,
  • Raphaëlle Larmet,
  • Luc Frimat,
  • Sophie Girerd,
  • Mathias Büchler,
  • Anne Renault,
  • Patrice Tirot,
  • Cécile Vigneau,
  • Eric Delpierre,
  • David Schnell,
  • Olivier Lesieur,
  • Lionel Rostaing,
  • Mathieu Lesouhaitier,
  • Laurent Martin-Lefevre,
  • Antoine Durrbach,
  • Noëlle Brulé,
  • Emmanuel Canet,
  • Maryvonne Hourmant,
  • Agnes Duveau,
  • Laurent Dube,
  • Marc Pierrot,
  • Stanislas Humbert,
  • Jean-Marc Boyer,
  • François Labadie,
  • Antoine Thierry,
  • Jean-François Vincent,
  • Angelique Goepp,
  • Pierre Bouju,
  • Charlotte Quentin,
  • Yannick Le Meur,
  • Jean-Christophe Venhard,
  • Olivier Michel,
  • Marie-Hélène Voellmy,
  • Fabien Herve,
  • Anne Courte,
  • Lucile Amrouche,
  • Marc Hazzan,
  • Valerie Moal,
  • Moglie Le Quintrec-Donnette,
  • Philippe Grimbert,
  • Anne Elisabeth Heng,
  • Pierre Merville,
  • Christian Hiesse,
  • Brice Fermier,
  • Charlotte Guyot-Colosio,
  • Nicolas Bouvier,
  • Jean-Philippe Rerolle,
  • Sarah Drouin,
  • Sophie Caillard,
  • Laetitia Albano,
  • Pierre-Francois Westeel,
  • Florent Montini,
  • Dider Dorez,
  • Eric Alamartine,
  • Carole Ouisse,
  • Veronique Sebille

DOI
https://doi.org/10.1136/bmjopen-2021-052845
Journal volume & issue
Vol. 12, no. 3

Abstract

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Introduction Expanded-criteria donors (ECDs) are used to reduce the shortage of kidneys for transplantation. However, kidneys from ECDs are associated with an increased risk of delayed graft function (DGF), a risk factor for allograft loss and mortality. HYPOREME will be a multicentre randomised controlled trial (RCT) comparing targeted hypothermia to normothermia in ECDs, in a country where the use of machine perfusion for organ storage is the standard of care. We hypothesise that hypothermia will decrease the incidence of DGF.Methods and analysis HYPOREME is a multicentre RCT comparing the effect on kidney function in recipients of targeted hypothermia (34°C–35°C) and normothermia (36.5°C–37.5°C) in the ECDs. The temperature intervention starts from randomisation and is maintained until aortic clamping in the operating room. We aim to enrol 289 ECDs in order to analyse the kidney function of 516 recipients in the 53 participating centres. The primary outcome is the occurrence of DGF in kidney recipients, defined as a requirement for renal replacement therapy within 7 days after transplantation (not counting a single session for hyperkalemia during the first 24 hours). Secondary outcomes include the proportion of patients with individual organs transplanted in each group; the number of organs transplanted from each ECD and the vital status and kidney function of the recipients 7 days, 28 days, 3 months and 1 year after transplantation. An interim analysis is planned after the enrolment of 258 kidney recipients.Ethics and dissemination The trial was approved by the ethics committee of the French Intensive Care Society (CE-SRLF-16-07) on 26 April 2016 and by the competent French authorities on 20 April 2016 (Comité de Protection des Personnes-TOURS-Région Centre-Ouest 1, registration #2016-S3). Findings will be published in peer-reviewed journals and presented during national and international scientific meetings.Trial registration number NCT03098706.