None listed
Conditions
Brief summary
Fifty patients undergoing liver transplant will be included in the study. The participants will be randomized in two groups using a software application. In SR group, simultaneous portal vein and hepatic artery reperfusion, while in IPR group an initial portal reperfusion and the hepatic artery reperfusion is subsequently performed. Both techniques are used in the clinical practice, it is based on the personal preference of the surgeon the type of perfusion technique used. There is no evidence that one technique of reperfusion is superior to another or harmful.Data regarding preoperative variables, intraoperative and postoperative variables are prospectively collected. A non-invasive device (called Sidestream Dark Field imaging), that allow for clinical observation of the microcirculation will be used. It is hand-held probe with a sterile extension for direct contact with liver parenchyma. Liver biopsies are performed to assess Immunohystochemical intensity of ET-1 and other markers. The tissue to be acquired in this study will be obtained from surgical specimens taken from consented participants having routine hepatic surgery or liver transplantation. The study additionally requires the provision of a blood sample for the serum assessment of ET-1 and other markers. This blood sample will be taken at the time of clinically indicated vensection. The risks involved in drawing blood from the arm include discomfort at the site of insertion of the needle and possible bruising/swelling around the injection site. There is a very rare risk of infection. There is also a remote possibility of fainting while blood is being drawn.
Interventions
The patients are randomised in two groups, simultaneous arterial and portal revascularization (SR group) and Initial
portal reperfusion (IPR).
In the IPR group the graft is revascularized through the portal vein, and the hepatic artery is subsequently performed. In the SR group the graft is
revascularized simultaneously through the portal vein, and hepatic artery. Both techniques are used in the clinical practice, it is based on the personal
preference of the surgeon. There is no evidence t
The patients are randomised in two groups, simultaneous arterial and portal revascularization (SR group) and Initial portal reperfusion (IPR). In the IPR group the graft is revascularized through the portal vein, and the hepatic artery is subsequently performed. In the SR group the graft is revascularized simultaneously through the portal vein, and hepatic artery. Both techniques are used in the clinical practice, it is based on the personal preference of the surgeon. There is no evidence that one technique of reperfusion is superior to another or harmful. However, there is a theoretical advantage to the simultaneous technique. A non-invasive device (called Sidestream Dark Field imaging), that allow for clinical observation of the microcirculation will be used 30 minutes after reperfusion. It is hand-held probe with a sterile extension for direct contact with target tissue. The objective of the device can be sterilized with a sterile cover and drape. Sidestream Dark Field imaging uses the absorption of hemoglobin to visualize the microcirculation using a polarized light technique, as consequence it is completely safe. Sidestream Dark Field imaging is used at the end of reperfusion for 5 minutes Blood sample for the serum assessment of ET-1 and other markers will be taken at indiction of anaesthesia amd post operative day 1-3-5-7.
Sponsors
Australian national liver transplantation unit Royal prince alfred hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
patient candidate to Liver transplant at Royal prince alfred hospital older than 18 years
Exclusion criteria
Split liver
Outcome results
None listed