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Effect of Ursodeoxycholic Acid Supplementation on Liver Regeneration on Right Lobe Donor Hepatectomy

Not Applicable
Not yet recruiting
Conditions
Partial Liver Resection
Liver Regeneration
Ursodeoxycholic Acid
Interventions
Other: Standard Medical Treatment
Registration Number
NCT06091787
Lead Sponsor
Institute of Liver and Biliary Sciences, India
Brief Summary

The goal of this open label randomized trial is to understand the role of oral ursodeoxycholic acid(UDCA) supplementation in the liver regeneration (in terms of liver function and anatomical growth) following right lobe donor hepatectomy. The main question it aims to answer are:

* Does Ursodeoxycholic acid supplementation on patients undergoing donor hepatectomy improve anatomical liver regeneration after partial hepatectomy as compared to control group.

* Does ursodeoxycholic acid improve liver regeneration in terms of liver function tests and biomarkers of liver regeneration(HGF, IL6, TNF Alpha, AFP, TGF Beta) as compared to control group.

Detailed Description

This open label randomized control study aims to analyze the effect of ursodeoxycholic acid supplementation on liver regeneration following a right donor hepatectomy. All eligible live donors who undergo right donor hepatectomy during the study period will be included in the study and randomized into two groups. One group will receive Tab. UDCA 450mg twice daily for 10 days and the other group will not receive Tab UDCA. Live donors who are not willing to participate in the study, have hypersensitivity to UDCA or have used Tab UDCA in the past 2 weeks, will be excluded from the study. All live donors will be screened in the pre-operative period in the outpatient department.

Pre- operative, intra-operative and post-operative data will be collected from medical records, electronic hospital information system (HIS) and radiological images collected from the hospital Picture archiving and communication system(PACS). The enrolled subjects will be followed up till for a period of 14 days after the donor hepatectomy till Non contrast CT Abdomen is done and regenerated liver volumes are analyzed. The anatomic(volumetric), functional(liver function tests) and regenerative biomarkers( HGF, TNF-Alpha, IL6, AFP, TGF-Beta) will be compared between the two groups.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria
  • All live donors undergoing Right Donor Hepatectomy in ILBS from ethical board clearance to December 2024 in the Department of HPB Surgery and Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi
Exclusion Criteria
  • Negative consent
  • Hypersensitivity to UDCA
  • Past history of UDCA use in the last two weeks

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control ArmStandard Medical TreatmentThis group will receive standard medical therapy following donor hepatectomy.
Study ArmUrsodeoxycholic acidThis group will recieve Tab Ursodeoxycholic acid 450mg twice daily from the day after donor hepatectomy till post operative day 10.
Primary Outcome Measures
NameTimeMethod
Regenerated liver volume on Post-operative Day 14 between two groups.14 days after operation

* This will be measured by a non contrast CT Abdomen and the size of the regenerated liver after hepatectomy will be measured in millilitres

* This value will be measured in both groups to identify a difference in the intervention group (getting UDCA) versus the control group ( standard medical therapy)

Liver Regeneration index POD 77 days after operation

Ratio of regenerated liver volume to remnant liver volume(pre-operative) on Post operative day 7

Liver Regeneration index POD 1414 days after operation

Ratio of regenerated liver volume to remnant liver volume(pre-operative) on Post operative day 14

Regenerated liver volume on Post-operative Day 7 between two groups.7 days after operation

* This will be measured by a non contrast CT Abdomen and the size of the regenerated liver after hepatectomy will be measured in millilitres

* This value will be measured in both groups to identify a difference in the intervention group (getting UDCA) versus the control group ( standard medical therapy)

Secondary Outcome Measures
NameTimeMethod
Direct bilirubinPost-operative day 1-7, 10 and 14

serum Direct bilirubin versus control group

Aspartate Aminotransferase(AST)Post-operative day 1-7, 10 and 14

serum AST versus control group

Serum AlbuminPost-operative day 1-7, 10 and 14

serum Albumin versus control group

Serum Alkaline Phosphatase(SAP)Post-operative day 1-7, 10 and 14

serum SAP versus control group

Total bilirubinPost-operative day 1-7, 10 and 14

serum total bilirubin versus control group

International normalized ratio(INR)Post-operative day 1-7, 10 and 14

INR versus control group

Post hepatectomy liver failure(PHLF)Post operative day 1-14

Grade of PHLF as per ISGLS criteria and 50/50 criteria

Abdominal Drain removalPost operative day 1-14

Day of abdominal drain removal

Alanine Aminotransferase(ALT)Post-operative day 1-7, 10 and 14

serum ALT versus control group

Serum Gamma Glutamyl Transferase(GGT)Post-operative day 1-7, 10 and 14

serum SAP versus control group

Post-operative complicationsPost operative day 1-14

Grade of post-operative complications as per Clavien-Dindo classification

Post-operative ascitesPost operative day 1-14

Volume of ascites

Trial Locations

Locations (1)

Institute of Liver and Biliary Sciences

🇮🇳

New Delhi, India

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