Liver Transplant
Conditions
Keywords
fluid management, blood loss
Brief summary
During liver transplantation, due to the complexity of the operation and abnormal coagulation function, there may be a large amount of bleeding and corresponding blood transfusion. Excessive blood transfusion will increase pulmonary complications and affect the prognosis. Infusion management to reduce bleeding is a very important issue in liver transplant surgery. Restrictive infusion management can effectively reduce the amount of bleeding in liver transplantation, but it remains unclear whether it will cause sequelae in other major organs. The investigators plan to study different infusion goals and strategies in liver transplant surgery using a randomized group model, using the PiCCO (Pulse Contour Cardiac Output) cardiopulmonary volume monitor, and setting the stroke volume variation (SVV) as the macroscopic circulation.The purpose of this study was to divide it into restrictive and liberal groups to explore the impact on liver transplantation bleeding volume and inflammatory response as well as postoperative lung and renal function, and to collect statistics on clinical care and postoperative sequelae (pulmonary liver, renal function impairment, etc.) in order to develop the most appropriate infusion management strategy in liver transplantation.
Interventions
OTHERLiberal group
Fluid challage to keep stroke volume variation \< 10%
OTHERrestrictive group
Fluid challage to keep stroke volume variation \< 18%
Sponsors
National Taiwan University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* end stage liver disease * age between 18y/o to 75 y/o * expected to recieve to receive liver transplantation
Exclusion criteria
* arrythmia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| blood loss intraoperatively | during the operation | blood loss intraoperatively in liver transplant |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lung injury biomarker | from biginning of the operation to postoprative day 1 | serum Clara Cell Protein (CC16) |
| Kidney injury biomarker | from biginning of the operation to postoprative day 1 | serum Neutrophil Gelatinase Associated Lipocalins (NGALs) |
| Influammatory reponses | from biginning of the operation to postoprative day 1 | IL-6 |
Countries
Taiwan
Contacts
Primary ContactKuang-Cheng Chan, M.D.,PhD.
Outcome results
None listed