Other Complications of Liver Transplant
Conditions
Keywords
Liver, transplant, albumin
Brief summary
The primary aim of this study is to assess the effect of hyperoncotic albumin on vascular hemodynamics and oxygen delivery after orthotopic liver transplant. The secondary aim is to try to identify the dominant physiological mechanism so that we will be able to better identify patients that may benefit from the use of albumin (25%) boluses in addition to standard care in patients following liver transplantation.
Interventions
DRUGSaline
100 ml of saline will be given in addition to the standard of care every 8 hours for 24 hours.
DRUG25% albumin
100 ml of 25% albumin will be given in addition to the standard of care every 8 hours for 24 hours
Sponsors
McGill University Health Centre/Research Institute of the McGill University Health Centre
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* 18 years or older * Patients from the Critical care Unit * Patients with a pulmonary artery occlusion catheter Inclusion:patients immediately following liver transplantation
Exclusion criteria
* Patients not giving informed consent * Patients who have received \> 300 ml of albumin within 24 hours prior to inclusion * Patients known to have previous adverse reaction to human albumin solution * Patients who have religious restriction to receive human blood products * Patient who have initial graft failure * Patients with fluctuating hemodynamics * Concerns of the treating surgeon
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cardiac index (CI) | 60 minutes after the infusion of the fluid |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cardiac function response | 30 and 60 minutes after the infusion of the fluid | An improvement in Q due primarily to a change in cardiac function should have an increase in Q of ≥ 0.3 ml/min/m2/mmHg |
| A decrease in leak and plasma expansion | 30 and 60 minutes after the infusion of the fluid | A decrease in leak and plasma expansion will be determined by the Harrison formula for calculating a change in plasma volume from the change in Hb and change in Hct |
| Cardiac output response | 30 and 60 minutes after the infusion of the fluid | Cardiac output response primarily due to a volume effect would be expected to have an increase of CVP of a minimum of 2 mmHg and an increase in CI of \> 0.3 L/min/m2 per mmHg. |
| Detoxification effect of albumin | 30 and 60 minutes after infusion | A increase in vascular tone will be identified by an increase in systemic vascular resistance or a rise in blood pressure without a change in cardiac output or a rise in blood pressure with a fall in cardiac output |
Countries
Canada
Contacts
Primary ContactSheldon Magder, MD
Backup ContactThomas Lescot, MD, PhD
Outcome results
None listed