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Fresh Frozen Plasma as a Substitute for Albumin in Patients Receiving a Large Volume Paracentesis

Phase 4
Withdrawn
Conditions
Ascites Hepatic
Liver Cirrhosis
Registration Number
NCT03202524
Lead Sponsor
Montefiore Medical Center
Brief Summary

Large volume paracentesis with albumin administration is the standard of care for patients with refractory ascites complicating end-stage liver disease. However, the use of albumin is frequently limited due to expense and occasional short supply. The goal of this study is to demonstrate if the administration of fresh frozen plasma (FFP) is as effective as albumin for volume expansion at the time of a large volume paracentesis.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  1. Age 18 years or older
  2. Cirrhosis of the liver based on biopsy or clinical and radiographic criteria
  3. Ability to provide informed consent (Grade 0 to 1 HE)
  4. Grade 3 ascites or refractory ascites
  5. Ascites requiring frequent large volume paracentesis of at least 5 liters at least once a month
  6. No diuretic use
Exclusion Criteria
  1. Inability to obtain informed consent
  2. Age less than 18
  3. Hepatic Encephalopathy Grade > 1
  4. Septic shock
  5. Active infection
  6. Respiratory failure
  7. Heart failure with reduced ejection fraction of ≤ 50%
  8. Moderate or severe pulmonary hypertension
  9. History of stroke
  10. Unstable coronary artery disease
  11. Chronic kidney disease (GFR <60)
  12. GI bleed within 2 weeks
  13. Any licorice within 2 weeks of starting the study
  14. Any Beta Blocker use within the last 2 weeks
  15. Any diuretic use within 2 weeks
  16. Absence of paracentesis within 2 weeks
  17. Absence of volume expanders within 2 weeks
  18. INR > 1.7

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Incidence of Post-Paracentesis Circulatory Dysfunction (PPCD)6 Days

The development of PPCD is diagnosed by an increase in plasma renin activity of more than 50% of baseline to \> 4 ng/mL/h on the 6th day post paracentesis

Secondary Outcome Measures
NameTimeMethod

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