Health Condition 1: K742- Hepatic fibrosis with hepatic sclerosis
Conditions
Interventions
Intervention1: Nil: Nil
Intervention2: Nil: Nil
Intervention3: Nil: Nil
Sponsors
Dr Rela Institute and Medical Centre
Eligibility
Inclusion criteria
Inclusion criteria: Recipient of a primary (first time) living donor, right lobe liver graft. Surgical procedure involving a modified right-lobe graft with documented reconstruction of one or more anterior sector venous tributaries.
Exclusion criteria
Exclusion criteria: Recipients of grafts from deceased donors, left lobe grafts, or extended right lobe grafts (where the native MHV is included). Paediatric recipients. Patients undergoing re-transplantation or multiorgan transplantation. Patients with a primary diagnosis of Budd Chiari syndrome or other pre existing hepatic venous outflow pathology. Patients who experience graft loss or develop EGD within the first 72 hours due to confounding causes such as hepatic artery thrombosis, primary non-function, hyperacute rejection, or overwhelming sepsis. Patients for whom a technically adequate Doppler ultrasound assessment cannot be obtained.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To determine the independent and interactive association of compromised anterior sector venous outflow (defined by the Anterior Sector Flow Index, ASFI) and anterior sector graft volume (defined by the Anterior Sector Graft to Recipient Weight Ratio, AS GRWR) with the incidence of Early Graft Dysfunction (EGD) within the first 30 postoperative days in adult recipients of modified right lobe LDLT.Timepoint: Intra-op, POD 1,3,5,7,14, then once weekly for 1 month | — |
Secondary
| Measure | Time frame |
|---|---|
| To establish a quantitative threshold for low anterior sector venous flow using a ratio of peak systolic velocities in the reconstructed AS vein and the Right Hepatic Vein, and to evaluate its performance in predicting EGD. Timepoint: Intra-op, POD 1,3,5,7,14, then once weekly for 1 month;To establish a pre-operative baseline donor hemodynamic ratio (MHV PSV to RHV PSV).Timepoint: Preoperative;To quantify the effect modification of AS-GRWR on the relationship between ASFI and EGD. Timepoint: Intra-op, POD 1,3,5,7,14, then once weekly for 1 month;To compare key clinical outcomes (e.g., peak bilirubin, INR, ICU stay, hospital stay, 30-day survival) between patients with compromised versus adequate AS venous outflow Timepoint: Intra-op, POD 1,3,5,7,14, then once weekly for 1 month;To explore the association between compromised AS venous outflow and the clinical diagnosis of Small-for-Size Syndrome (SFSS).Timepoint: Intra-op, POD 1,3,5,7,14, then once weekly for 1 month;To calculate a Reconstruction Efficiency percentage by comparing the recipients post implantation flow index to the donors baseline ratio and explore its association with EGD.Timepoint: Intra-op, POD 1,3,5,7,14, then once weekly for 1 month | — |
Countries
India
Contacts
Public ContactDr Ashwin Rammohan
Dr Rela Institute and Medical Centre
Outcome results
None listed