Hepato-duodenal Ligament Occlusion and Classic Technique in Liver Transplant

NCT04265157 | Unknown

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

Brief Summary

Liver transplantation was historically associated with massive blood loss. Many factors have contributed to the decline in bleeding and transfusion in the past two decades including refinement of surgical techniques, anesthetics management and the use of point of care guided goal-directed hemostatic therapies. Increasing awareness of the adverse associations of allogenic transfusion has driven the quest for transfusion-free transplantation. Pre-operative management of preoperative anemia and targeted correction of coagulopathy is done to decrease blood transfusion. Liver transplantation is associated with the potential for massive operative blood loss, which has been recognized as one of the main causes of morbidity and mortality after liver transplantation. Therefore, a fine surgical procedure to reduce intraoperative hemorrhage is necessary for favorable outcomes of liver transplantation.

Conditions

Liver Transplant

Outcome Measures

Primary Outcomes (1)

• The amount of intraoperative blood loss measure by Cubic Cm

  2 hours

Study Arms (2)

Early occlusion of hepatoduodenal ligament

Early occlusion of hepatoduodenal ligament during mobilization of the liver of the recipient by using portal vein clamp or occlusive temporary bands.

Procedure: Surgical technique surgical occlusion

classical occlusion of hepatoduodenal ligament

classical occlusion of hepatoduodenal ligament after mobilization of the liver of the recipient immediately before explantation by suing of portal vein clamp

Procedure: Surgical technique surgical occlusion

Interventions

Surgical technique surgical occlusion PROCEDURE

Occlusion of hepatoduodenal ligament by clamp or occlusive bands

Early occlusion of hepatoduodenal ligament; classical occlusion of hepatoduodenal ligament

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 LiverTransplantation (LDLT) according to hospital protocol

You may qualify if:

• All patients undergoing Living Donor Liver Transplantation accepted according to hospital protocol
• All patients with liver Cirrhosis who have Porto systemic collaterals based on ct angiography

You may not qualify if:

• Acute fulminant liver failure

Sponsors & Collaborators

• Assiut University: lead

Related Publications (8)

• Donohue CI, Mallett SV. Reducing transfusion requirements in liver transplantation. World J Transplant. 2015 Dec 24;5(4):165-82. doi: 10.5500/wjt.v5.i4.165.

  PMID: 26722645 BACKGROUND

• Park YK, Kim BW, Wang HJ, Xu W. Usefulness of the Pinch-Burn-Cut (PBC) technique for recipient hepatectomy in liver transplantation. Korean J Hepatobiliary Pancreat Surg. 2012 Feb;16(1):13-6. doi: 10.14701/kjhbps.2012.16.1.13. Epub 2012 Feb 29.

  PMID: 26388900 BACKGROUND

• Houben P, Khajeh E, Hinz U, Knebel P, Diener MK, Mehrabi A. SEALIVE: the use of technical vessel-sealing devices for recipient hepatectomy in liver transplantation: study protocol for a randomized controlled trial. Trials. 2018 Jul 16;19(1):380. doi: 10.1186/s13063-018-2778-1.

  PMID: 30012178 BACKGROUND

• Choi JU, Hwang S, Ahn CS, Moon DB, Ha TY, Kim KH, Song GW, Jung DH, Park GC, Lee SG. Prolonged occlusion of the hepatoduodenal ligament to reduce risk of bleeding and tumor spread during recipient hepatectomy for living donor liver transplantation. Ann Hepatobiliary Pancreat Surg. 2019 Feb;23(1):61-64. doi: 10.14701/ahbps.2019.23.1.61. Epub 2019 Feb 28.

  PMID: 30863809 BACKGROUND

• Lee KF, Wong J, Cheung SYS, Chong CCN, Hui JWY, Leung VYF, Yu SCH, Lai PBS. Does Intermittent Pringle Maneuver Increase Postoperative Complications After Hepatectomy for Hepatocellular Carcinoma? A Randomized Controlled Trial. World J Surg. 2018 Oct;42(10):3302-3311. doi: 10.1007/s00268-018-4637-3.

  PMID: 29696328 BACKGROUND

• Cleland S, Corredor C, Ye JJ, Srinivas C, McCluskey SA. Massive haemorrhage in liver transplantation: Consequences, prediction and management. World J Transplant. 2016 Jun 24;6(2):291-305. doi: 10.5500/wjt.v6.i2.291.

  PMID: 27358774 BACKGROUND

• Yoon JU, Byeon GJ, Park JY, Yoon SH, Ryu JH, Ri HS. Bloodless living donor liver transplantation: Risk factors, outcomes, and diagnostic predictors. Medicine (Baltimore). 2018 Dec;97(50):e13581. doi: 10.1097/MD.0000000000013581.

  PMID: 30558025 BACKGROUND

• Kornberg A, Witt U, Kornberg J, Ceyhan GO, Mueller K, Friess H, Thrum K. Prognostic Impact of Intraoperative Blood Loss in Liver Transplant Patients with Advanced Hepatocellular Carcinoma. Anticancer Res. 2016 Oct;36(10):5355-5364. doi: 10.21873/anticanres.11109. Epub 2016 Oct 10.

  PMID: 27798899 BACKGROUND

Central Study Contacts

Ahmed Elkoussy, Master

CONTACT

+20010!17739; ahmdkoussy91@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: January 29, 2020
• First Posted: February 11, 2020
• Study Start: March 1, 2020
• Primary Completion: March 1, 2022
• Study Completion: September 1, 2022
• Last Updated: February 11, 2020

Record last verified: 2020-02