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Pharmacological Study of Cefazolin Antibioprophylaxis in Liver Transplantation

Withdrawn
Conditions
Surgical Site Infection
Antibiotic Prophylaxis
Cephazolin Adverse Reaction
Liver Transplant Infection
Interventions
Other: Blood samples
Registration Number
NCT04280237
Lead Sponsor
University Hospital, Tours
Brief Summary

This study describes Cefazolin pharmacokinetics variation to target levels during liver transplantation.

Detailed Description

Cefazolin is one of the many drugs used in antibiotic prophylaxis during liver transplantation. However there are no study describing its pharmacokinetics during liver transplantation.

Due to the severe pharmacokinetics interactions caused by both prior hepatopathy and surgical techniques we suppose that Cefazolin blood levels are very different from those targeted for antibiotic prophylaxis.

This study aim to describe pharmacokinetics of Cefazolin during liver transplantation in order to adapt antibiotic prophylaxis strategy in case of unadapted measured levels.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Age over 18
  • patient undergoing liver transplantation
  • receiving Cefazolin as perioperative antibiotic prophylaxis to prevent surgical site infections
Exclusion Criteria
  • pregnant women
  • legal protection or protected adults
  • ongoing antibiotic treatment before liver transplantation
  • patient inability to receive information or express opposition to the study.
  • patient refusing participation

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Cefazolin in liver transplantationBlood samplesPatient undergoing liver transplant surgery and receiving antibiotic prophylaxis with Cefazolin
Primary Outcome Measures
NameTimeMethod
Cefazolin blood concentrationBaseline up to 10 hours

Cefazolin blood concentration will be measured at the moment of surgical incision and every hour until end of surgery

Secondary Outcome Measures
NameTimeMethod
Assess correlations between Cefazolin blood concentration and Cirrhosis etiologybaseline

Cause of cirrhosis

Assess correlations between Cefazolin blood concentration and Blood lossEnd of surgery

Blood loss quantification will be done throughout surgery

Assess correlations between Cefazolin blood concentration and CHILD-PUGH scorebaseline

Patient's CHILD-PUGH score before transplantation

Assess correlations between Cefazolin blood concentration and Hemodialysisbaseline

Patient needing hemodialysis before liver transplantation

Assess correlations between Cefazolin blood concentration and MELD scorebaseline

Patient's MELD score before transplantation

Assess correlations between Cefazolin blood concentration and Transplantation indicationbaseline

Cause leading to transplantation

Assess correlations between Cefazolin blood concentration and AscitisBaseline

Volume of ascitis drained at the beginning of surgery

Assess correlations between Cefazolin blood concentration and Urine outputEnd of surgery

Volume of urine output during surgery

Assess correlations between Cefazolin blood concentration and Red cell transfusion unitEnd of surgery

The number of red cell units transfused during transplantation will be counted at the end of surgery

Assess correlations between Cefazolin blood concentration and Plasma transfusion unitEnd of surgery

The number of plasma units transfused during transplantation will be counted at the end of surgery

Assess correlations between Cefazolin blood concentration and Colloid infusionEnd of surgery

Volume of colloid infusion during surgery

Assess correlations between Cefazolin blood concentration and Portal vein clamping timeEnd of surgery

Time of portal vein clamping and declamping during realization of vascular anastomosis will be noted

Assess correlations between Cefazolin blood concentration and Intraoperative blood salvageEnd of surgery

Intraoperative blood salvage transfusion volume during surgery

Assess correlations between Cefazolin blood concentration and Surgical site infectionDay 28

Number of patient with surgical site infection in the 28 days post-surgery

Assess correlations between Cefazolin blood concentration and Transjugular intrahepatic portosystemic shunt (TIPS)baseline

Medical history of TIPS

Assess correlations between Cefazolin blood concentration and Creatininebaseline

Creatinine levels will be measured before transplantation

Assess correlations between Cefazolin blood concentration and Surgery durationEnd of surgery

Time of surgical incision and end of the surgery will be noted

Assess correlations between Cefazolin blood concentration and Crystalloid infusionEnd of surgery

Assess correlations between Cefazolin blood concentration and Volume of crystalloid infusion during surgery

Assess correlations between Cefazolin blood concentration and Basal cardiac indexBaseline

Cardiac index value at the beginning of surgery

Assess correlations between Cefazolin blood concentration and Minimal cardiac indexEnd of surgery

Minimal index value during surgery

Assess correlations between Cefazolin blood concentration and Albuminbaseline

Albumin levels will be measured before transplantation

Assess correlations between Cefazolin blood concentration and Platelet transfusion unitEnd of surgery

The number of platelet units transfused during transplantation will be counted at the end of surgery

Trial Locations

Locations (1)

Surgical intensive care unit, University Hospital, Tours

🇫🇷

Tours, France

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