Liver Transplantation Donation after Circulatory Death (DCD) Biliary Complications Hemodynamic Stability Early Allograft Disfunction (EAD) Lever Transplantatie Donatie na Circulatie Arrest Galweg Complicaties Hemodynamische stabiliteit Vroege Transplantaatfunctie
Conditions
Interventions
Experimental artery reperfusion first, or standard portal vein reperfusion first in recipients of a DCD donor liver graft
Sponsors
Erasmus MC Rotterdam
Eligibility
Inclusion criteria
Inclusion criteria: - Age over 18 years of age - On the active waiting list for liver transplantation - Foreseen to be offered a donation after circulatory death (DCD) liver graft - Written informed consent for this trial
Exclusion criteria
Exclusion criteria: - Contra-indications for DCD liver graft - Split or reduced liver grafts - Technical contra-indications to arterial reperfusion within 45 minutes (need for vascular reconstructions, jump grafting etc. during warm ischemic period) - Multi-organ transplantation - Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Occurrence of any biliary complication (leakage, non-anastomotic stricture (NAS) / Ischemia Type Biliary Lesion (ITBL), within the first year post-transplant, for which additional invasive intervention (ERCP, PTC), or drug therapy, other than prescription of ursodeoxicholic acid, is needed. | — |
Secondary
| Measure | Time frame |
|---|---|
| A. Hemodynamic stability at reperfusion, measured as the area under the curve of vasoactive inotropic support in the first hour after reperfusion of the liver graft and the duration of mean arterial blood pressure below 60 mm Hg within the first hour of reperfusion. B. Incidence of Early Allograft Dysfunction within the first week of liver transplantation, defined by the Olthoff Criteria | — |
Contacts
Public ContactH. Hartog
Department of Hepatobiliary Surgery Erasmus Medical Center PO Box 2040
Outcome results
None listed