Outflow Reconstruction in Right Lobe Living Donor Liver Transplantation

NCT03666689 | Unknown

• 1 other identifier: MHV reconstruction in LDLT
• Study Type: observational
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

Modified Right Lobe Graft(MRLG) is one of the most common used graft in liver transplantation .Anterior sector of allograft in MRLG usually congested to decrease this congestion tributaries of middle hepatic vein should be drained to inferior vena cava . There are too many techniques available for this drainage using either cryopreserved or synthetic graft for vascular anastomosis .In this study we will compare between two different technique using ringed synthetic polytetrafluoroethylene (PTFE) graft to assess outflow adequacy in both technique.

Conditions

Liver Transplant

Outcome Measures

Primary Outcomes (1)

• Outflow adequacy of liver graft within the first 6 month post transplant

  Outflow adequacy of the graft will be assessed intraoperatively by the presence of the congestion and the color of the graft and Doppler ultrasound will be done after vascular reconstruction and before closure of anterior abdominal wall. Outflow adequacy will be assessed postoperatively by Doppler ultrasound once per day for the first 5 days, then once per week for 4 weeks then 2,3,and 6 months. Computed tomography (CT) scan will be done in the 6 postoperative month

  6 month

Study Arms (2)

MHV reconstruction

Both ends of middle hepatic vein tributaries V8 and/or V5 of modified right lobe graft will be anastomosed to side of a single synthetic graft which will be anastomosed to recipient's middle/left hepatic vein orifice.

Procedure: surgical technique

Separate tributaries reconstruction

End of V8 middle hepatic vein tributary of modified right lobe graft; if present, will be anastomosed to end of a synthetic graft which will be anastomosed to recipient's middle/left hepatic vein orifice, and end of V5; if present; will be anastomosed to end of a synthetic graft which will be anastomosed to recipient's Inferior Vena Cava directly.

Procedure: surgical technique

Interventions

surgical technique PROCEDURE

surgical reconstruction

MHV reconstruction; Separate tributaries reconstruction

Eligibility Criteria

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

Study Population

We will included in the study all patients accepted for Living Donor Liver Transplantation (LDLT) according to hospital protocol

You may qualify if:

• All patients undergoing Living Donor Liver Transplantation(LDLT) accepted according to hospital protocol
• Written informed consent obtained
• patient undergoing venous reconstruction either segment 5 or segment 8 vein or both

You may not qualify if:

• Acute fulminant liver failure

Sponsors & Collaborators

• Assiut University: lead

Related Publications (4)

• Lo CM, Fan ST, Liu CL, Wei WI, Lo RJ, Lai CL, Chan JK, Ng IO, Fung A, Wong J. Adult-to-adult living donor liver transplantation using extended right lobe grafts. Ann Surg. 1997 Sep;226(3):261-9; discussion 269-70. doi: 10.1097/00000658-199709000-00005.

  PMID: 9339932 BACKGROUND

• Fan ST, Lo CM, Liu CL, Wang WX, Wong J. Safety and necessity of including the middle hepatic vein in the right lobe graft in adult-to-adult live donor liver transplantation. Ann Surg. 2003 Jul;238(1):137-48. doi: 10.1097/01.sla.0000077921.38307.16.

  PMID: 12832976 BACKGROUND

• Yi NJ, Suh KS, Lee HW, Cho EH, Shin WY, Cho JY, Lee KU. An artificial vascular graft is a useful interpositional material for drainage of the right anterior section in living donor liver transplantation. Liver Transpl. 2007 Aug;13(8):1159-67. doi: 10.1002/lt.21213.

  PMID: 17663413 BACKGROUND

• Hwang S, Jung DH, Ha TY, Ahn CS, Moon DB, Kim KH, Song GW, Park GC, Jung SW, Yoon SY, Namgoong JM, Park CS, Park YH, Park HW, Lee HJ, Lee SG. Usability of ringed polytetrafluoroethylene grafts for middle hepatic vein reconstruction during living donor liver transplantation. Liver Transpl. 2012 Aug;18(8):955-65. doi: 10.1002/lt.23456.

  PMID: 22511404 BACKGROUND

MeSH Terms

Interventions

Wound Closure Techniques

Intervention Hierarchy (Ancestors)

Surgical Procedures, Operative

Central Study Contacts

Ahmed Abdalla, master

CONTACT

+2001018942253; draboabdalla33@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assisstant lecturer

Study Record Dates

• First Submitted: September 9, 2018
• First Posted: September 12, 2018
• Study Start: October 1, 2018
• Primary Completion: October 1, 2020
• Study Completion: May 1, 2021
• Last Updated: September 12, 2018

Record last verified: 2018-09