NCT04564651

Brief Summary

Acute on-chronic liver failure (ACLF) is a severe liver disease with a 28-day mortality rate of up to 40%. When the patients get 3 or more organ failures, the 28-day mortality rate is up to 82.6%. Though the ACLF patients have high short-term mortality, and the only effective treatment method is liver transplantation. However, few patients can be treated due to the scarcity of liver source, rapid disease progression and short transplantation window. Our team evaluated the platelet function of 100 patients with ACLF by using the thromboelastograghy (TEG 5000). It was found for the first time that the reactivity of platelets of ACLF patients decreased, and the platelet inhibition rate (especially the ADP pathway) was related to patients'short-term prognosis. When the ADP inhibition rate was 70%, the patients'28-day mortality was up to 100%. However, the mechanism of low platelet response to ADP in ACLF patients is still unclear. We found that the platelet function in patients with ACLF 2-3 grade and inhibition rate beyond 70% was improved and the 28-day mortality decreased after platelet transfusion. Whether platelet transfusion can prolong survival time needs to be determined in a prospective controlled study. Therefore, this study is expected to find a new therapeutic method to reduce the mortality of patients with ACLF.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
80

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started May 2019

Longer than P75 for not_applicable

Geographic Reach
1 country

8 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 1, 2019

Completed
1.4 years until next milestone

First Submitted

Initial submission to the registry

September 18, 2020

Completed
7 days until next milestone

First Posted

Study publicly available on registry

September 25, 2020

Completed
3.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2024

Completed
Last Updated

September 25, 2020

Status Verified

September 1, 2020

Enrollment Period

5 years

First QC Date

September 18, 2020

Last Update Submit

September 21, 2020

Conditions

Outcome Measures

Primary Outcomes (1)

  • 28-day transplant-free mortality

    whether participant died or not without liver transplantation

    28 days

Secondary Outcomes (1)

  • 90-day transplant-free mortality

    90 days

Study Arms (2)

platelet transfusion treatment

EXPERIMENTAL
Other: platelet transfusion

standard medical treatment

NO INTERVENTION

Interventions

when the ADP inhibition \>70%, give one unit platelet tansfusion

platelet transfusion treatment

Eligibility Criteria

Age16 Years - 60 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • years old;
  • Patients with compensated cirrhosis conformed to the (ACLF) diagnostic criteria of chronic and acute liver failure defined by the European Association of Hepatology (EASL-CLIF), and met the ACLF-2 and 3 grades.
  • ADP inhibition rate ≥ 70%.

You may not qualify if:

  • Patients with severe platelet allergy in the past;
  • Coma caused by cerebral hemorrhage or primary diseases of the nervous system;
  • Those who have taken anti-platelet drugs or anticoagulants within four weeks;
  • Rupture and bleeding of EVB occurred within 1 week.
  • Those who received platelet transfusion within 1 week;
  • Patients with liver cancer or other malignant tumors;
  • Pregnant and lactating women;
  • Complicated with other serious chronic diseases;
  • Not signing the informed consent form;
  • Other researchers do not consider it appropriate to participate in the study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (8)

The First Affiliated Hospital of Army Medical University

Chongqing, Chongqing Municipality, China

RECRUITING

Nanfang Hospital

Guangzhou, Guangdong, 510515, China

RECRUITING

Taihe Hospital affiliated to Hubei Medical College

Shiyan, Hubei, China

RECRUITING

Xiangya Hospital Central South University

Changsha, Hunan, China

RECRUITING

The First Affiliated Hospital of Jilin University

Changchun, Jilin, China

RECRUITING

The First Affiliated Hospital of Xinjiang Medical University

Xinjiang, Xinjiang, China

RECRUITING

Meng Chao Hepatobiliary Hospital of Fujian Medical University

Fujian, China

RECRUITING

Shanghai Public Health Clinical Center

Shanghai, China

RECRUITING

MeSH Terms

Conditions

Acute-On-Chronic Liver Failure

Interventions

Platelet Transfusion

Condition Hierarchy (Ancestors)

Liver Failure, AcuteLiver FailureHepatic InsufficiencyLiver DiseasesDigestive System Diseases

Intervention Hierarchy (Ancestors)

Blood Component TransfusionBlood TransfusionBiological TherapyTherapeutics

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Director

Study Record Dates

First Submitted

September 18, 2020

First Posted

September 25, 2020

Study Start

May 1, 2019

Primary Completion

May 1, 2024

Study Completion

May 1, 2024

Last Updated

September 25, 2020

Record last verified: 2020-09

Data Sharing

IPD Sharing
Will not share

Locations