Hepatic Insufficiency, Blood Coagulation Disorders
Conditions
Keywords
Thrombelastography, Antithrombin proteins, Liver surgery, Liver function tests
Brief summary
The aim of this study is to evaluate early clotting disorders through thromboelastogram and anticoagulant proteins levels (maybe also endothelial markers) and liver function by indocyanine green clearance after major liver resection and search for a potential relationship between them.
Detailed description
We are prospectively recording data from patients undergoing major liver resection. We obtain a full procoagulant and anticoagulant profile preoperatively and, at first, second and sixth day after surgery. We also measure indocyanine green (ICG) clearance preoperatively and in the first two postoperative days. We are also recording clinical data, focusing on medical and surgical complications. We aim to establish the potential value of ICG clearance and or coagulation profile to predict clinical complications
Interventions
DRUGIndocyanine green clearance
To evaluate liver function by injection of indocyanine green by a peripheral vein and measure its clearance
OTHERThromboelastometry
To evaluate blood coagulation impairment by obtaining blood sample from a peripheral vein and measure anticoagulant proteins levels plus obtaining thromboelastometry
Sponsors
Hospital General Universitario Gregorio Marañon
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing major liver surgery defined as resection of 3 or more hepatic segments
Exclusion criteria
* Indocyanin green allergy * Thyrotoxicosis * Thrombophilia * Lupus anticoagulant * Coagulation factor deficiency * Venous thromboembolism in the last 3 years * Pulmonary thromboembolism in the last 3 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Establish a relationship between ICG and MCF | 1 week | We aim to find a potential association between ICG and MCF measured by thromboelastometry in the first week after surgery |
| Establish a relationship between pro and anticoagulant proteins levels and endothelial markers | 1 week | We aim to find a potential association between procoagulant factor levels, protein C,S and ATIII with thrombomodulin, heparan sulfate and syndecan-1 in the first week after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Study blood coagulation disorders after major liver surgery resection | 2 years | We aim to characterize blood coagulation disorders during the first week after major liver surgery in our sample of patients |
| Study liver function after major liver surgery | 2 years | We aim to study the predictive value of indocyanine green clearance for liver impairment after major liver surgery in our sample of patients |
Countries
Spain
Outcome results
None listed