Complication, Postoperative, Liver Transplantation, Neurologic Deficits, Ultrasonography, Doppler, Transcranial
Conditions
Brief summary
This is a prospective study that would investigate the transcranial doppler (TCD) changes during the living donor liver transplantation and the association between the TCD changes and the post-transplant neurological complications.
Detailed description
Objectives: Participants & Setting: Intervention & Measurements: Sample size:
Interventions
DIAGNOSTIC_TESTTranscranial Doppler
Transcranial Doppler-derived parameters; pulsatility index (PI), resistance index (RI), mean flow velocity (Vmean) will be recorded before induction of anesthesia (T1). After induction, TCD parameters, Hemodynamic variables including heart rate (HR), invasive mean arterial blood pressure (MAP), and central venous pressure (CVP) together with Arterial blood gases (ABG analysis with values of PH, PCO2, PO2, blood oxygen saturation SO2 and bicarbonate HCO3), end-tidal carbon dioxide (ETCO2) and body temperature will be recorded too. Just before skin incision (T2), at the end of anhepatic phase 5 minutes before reperfusion (T3), 5 minutes after reperfusion (T4) and at the end of surgery (T5). Postoperatively at ICU, TCD parameters, Hemodynamic variables, and ABG will be obtained 24 hours postoperative (T6) and at discharge from ICU (T7).
Sponsors
Mansoura University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SCREENING
Masking
NONE
Intervention model description
A single-arm trial involving 100 patients undergoing living donor liver transplantation; all will be examined using transcranial doppler to find out its predictive value on post-transplant neurological deficits.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* all patients scheduled for living donor liver transplantation for whatever the indication at Gastrointestinal surgery center (GISC)
Exclusion criteria
* Patients with coexisting neuropsychiatric or cerebrovascular disorders or those who have a history of head trauma or brain surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post-transplant Neurological Complication | 28 days after transplantation | incidence of Neurological Complication as a composite outcome (tremors, seizures, demyelination, posterior reversible encephalopathy syndrome, stroke) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| flow patterns throughout the transplant surgery and in the ICU | intraoperative and 7 days after transplantion | normal, hyperemic, low-flow, or vasospastic flow by TCD |
Countries
Egypt
Contacts
Primary ContactMoataz M Emara, MD, EDAIC
Backup ContactKareem M Abozeid, MSc
Outcome results
None listed