Condition 1: liver transplantation patients. Condition 2: cirrhotic patients. Liver transplant failure and rejection Fibrosis and cirrhosis of liver
Conditions
Interventions
Intervention 1: Intervention group: First intervention group: Initial dose of Vancomycin is determined according to the renal function estimation by GRAIL (Glomerular filtration Rate Assessment In Liv
Sponsors
Tehran University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Adults recipients of liver transplant who are more than 18 years old and they are admitted in liver transpalnt ward and receiving Vancomycin antibiotic. The plasma creatinine should be in a steady level for at least 48 to 72 hours (variation of less than 0.3mg/dL is acceptable). The estimated rate of kidney function of included patients should be less than 90mL/min according to Cockcroft-Gault equation. Patients should sign the informed consent.
Exclusion criteria
Exclusion criteria: Patients who take medications (such as Cefazolin, Cimetidine, high dose of vitamin C, Methyldopa) which they interact with creatinine level measurement should be excluded from the study except patients taking Cotrimoxazole. Each patient should take the PCP prophylaxis dose of Cotrimoxazole. Patients who are candidate for receiving therapeutic dose of Cotrimoxazole are not excluded from the study and their kidney function is evaluated before administration of Cotrimoxazole. Patients who receive liver and kidney transplant simultaneously. Retransplant patients. Patients who require dialysis due to acute or chronic renal failure. Pregnant and lactating women. Patients who receive Albumin (up to 2 days after receiving Albumin).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Trough Vancomycin blood level (trough concentration of fourth and fifth dose). Timepoint: Blood level of Vancomycin within 30 minutes before administration of next dose of the drug. Method of measurement: laboratory specimen by means of fluorescence polarization immunoassay.;Peak Vancomycin blood level (peak of the fourth dose). Timepoint: 1.5 to 2.5 hours after a one hour infusion or one hour after a 2 hours infusion due to completion of distribution phase. Method of measurement: laboratory specimen by means of fluorescence polarization immunoassay.;Area under the time-concentration cure of Vancomycin. Timepoint: It is calculated for fourth dose of the dug. Method of measurement: It will be calculated by pharmacokinetic formula. | — |
Secondary
| Measure | Time frame |
|---|---|
| Evaluation of length of hospital stay. Timepoint: Daily from the start of Vancomycin administration until the time of discharge from the hospital. Method of measurement: Counting the days of hospital stay.;Evaluation of duration of antibiotic therapy. Timepoint: Daily from the start of antibiotic treatment until the end of antibiotic therapy duration. Method of measurement: Counting the days that patient receives antibiotic. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactYasaman Saee
Tehran University of Medical Sciences
Outcome results
None listed