Superior Vena Cava and Its Relationship to Central Venous Pressure Measurements in Liver Transplantation

NCT02818218 | Completed Results

• 1 other identifier: 16-307
• Study Type: observational
• Target: 58
• Locations: 1 country
• Sites: 1

Brief Summary

Consecutive patients undergoing liver transplant surgery will be included in the study. Before surgical incision, during the preanhepatic phase, during the anhepatic phase, during the postanhepatic phase and following closure of the deep fascial layer of the anterior abdominal wall simultaneous measurement of SVC diameter, SBC collapsibility index and CVP will be recorded.

Conditions

Liver Failure

Outcome Measures

Primary Outcomes (4)

• Central Venous Pressure (CVP)

  Central Venous Pressure (CVP) reflects the amount of blood returning to the heart (venous return) and the ability of the heart to pump the blood into the arterial system. It was captured electronically via an automated record-keeping system. CVP were recorded by experienced anesthesiologists with expertise and qualifications in TEE at five key time points: before surgical incision, start of the preanhepatic phase, start of the anhepatic phase, start of the postanhepatic phase, and after closure of the deep fascial layer of the anterior abdominal wall. Low CVP (\< 2 mmHg) suggests hypovolemia, dehydration, or blood loss, while normal CVP (2-8 mmHg) indicates balanced fluid status. A high CVP (\> 8 mmHg) may indicate fluid overload, right heart failure, pulmonary hypertension, or cardiac tamponade.

  From the time patients enter the operating room to leaving the operating room, up to 24 hours.

• Correlation of Central Venous Pressure (CVP) and Superior Vena Cava (SVC) Collapsibility Index

  The Superior Vena Cava (SVC) Collapsibility Index is used to assess intravascular volume status and fluid responsiveness. The Superior Vena Cava (SVC) collapsibility index was obtained from (Maximum Diameter-Minimum Diameter)/(Maximum Diameter)\*100%. Central Venous Pressure (CVP) and SVC were recorded simultaneously by experienced anesthesiologists with expertise and qualifications in TEE at five key time points: before surgical incision, start of the preanhepatic phase, start of the anhepatic phase, start of the postanhepatic phase, and after closure of the deep fascial layer of the anterior abdominal wall. The interpretation of the SVC Collapsibility Index is categorized as follows: \< 20% indicates low collapsibility, suggesting adequate or high intravascular volume; 20-36% represents an indeterminate zone, requiring additional assessment to determine fluid responsiveness; and \> 36% reflects high collapsibility, suggesting hypovolemia or significant fluid deficit.

  From the time patients enter the operating room to leaving the operating room, up to 24 hours.

• Correlation of Central Venous Pressure (CVP) and Minimum Diameter of Superior Vena Cava (SVC)

  The diameter of Superior Vena Cava (normal diameter: 12-22 mm) ) was obtained using transesophageal echocardiography (TEE). Central Venous Pressure (CVP) and SVC were recorded simultaneously by experienced anesthesiologists with expertise and qualifications in TEE at five key time points: before surgical incision, start of the preanhepatic phase, start of the anhepatic phase, start of the postanhepatic phase, and after closure of the deep fascial layer of the anterior abdominal wall.

  From the time patients enter the operating room to leaving the operating room, up to 24 hours.

• Correlation of Central Venous Pressure (CVP) and Maximum Diameter of Superior Vena Cava (SVC)

  The diameter of the Superior Vena Cava (normal diameter: 12-22 mm) ) was obtained using transesophageal echocardiography (TEE). Central Venous Pressure (CVP) and SVC were recorded simultaneously by experienced anesthesiologists with expertise and qualifications in TEE at five key time points: before surgical incision, start of the preanhepatic phase, start of the anhepatic phase, start of the postanhepatic phase, and after closure of the deep fascial layer of the anterior abdominal wall.

  From the time patients enter the operating room to leaving the operating room, up to 24 hours.

Secondary Outcomes (4)

• Cardiac Index

  From the time patients enter the operating room to leaving the operating room, up to 24 hours.

• Correlation of Cardiac Index (CI) and Superior Vena Cava (SVC) Collapsibility Index

  From the time patients enter the operating room to leaving the operating room, up to 24 hours.

• Correlation of Cardiac Index (CI) and Minimum Diameter of Superior Vena Cava (SVC)

  From the time patients enter the operating room to leaving the operating room, up to 24 hours.

• Correlation of Cardiac Index (CI) and Maximum Diameter of Superior Vena Cava (SVC)

  From the time patients enter the operating room to leaving the operating room, up to 24 hours.

Interventions

Liver Transplant PROCEDURE

liver transplant recipient surgery

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Adult patients undergoing liver transplantation surgery (cadaveric and living related)

You may qualify if:

• years of age
• undergoing liver transplantation surgery (cadaveric and living related)

You may not qualify if:

• Contraindication to Transesophageal echocardiography

Sponsors & Collaborators

• The Cleveland Clinic: lead

Study Sites (1)

Cleveland Clinic Foundation

Cleveland, Ohio, 44195, United States

Location

MeSH Terms

Conditions

Liver Failure

Interventions

Liver Transplantation

Condition Hierarchy (Ancestors)

Hepatic Insufficiency; Liver Diseases; Digestive System Diseases

Intervention Hierarchy (Ancestors)

Tissue Transplantation; Cell- and Tissue-Based Therapy; Biological Therapy; Therapeutics; Digestive System Surgical Procedures; Surgical Procedures, Operative; Organ Transplantation; Transplantation

Results Point of Contact

• Title: YanYan Han
• Organization: Cleveland Clinic Foundation

HANY3@ccf.org

216-444-2250

Study Officials

• Daniel Sessler

  Outcomes Research Institute

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 11, 2016
• First Posted: June 29, 2016
• Study Start: July 1, 2016
• Primary Completion: May 1, 2019
• Study Completion: September 1, 2020
• Last Updated: August 7, 2025
• Results First Posted: August 7, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)