Impact of Splenic Artery Ligation in Living Donor Liver Transplantation for Patients With Portal Hypertension on Early Graft Function.
试验速览
- 阶段
- 不适用
- 入组人数
- 30
- 主要终点
- Incidence of early graft dysfunction
研究概览
简要总结
In this study, the investigators aim to prove that performing splenic artery ligation in living donor liver transplantation for patients with portal hypertension is beneficial for early graft function postoperatively. The investigators will be analyzing trend of LFT's (liver function tests) after surgery, time for normalization of bilirubin, INR (international normalised ratio) and decrease in ascites, morbidity, mortality, ICU (intensive care unit) and total hospital stay.
详细描述
Liver transplantation (LT) is the principal treatment for end-stage liver diseases and selected cases of liver neoplasms . Living donor liver transplantation (LDLT) serves as a sole source of liver graft in some countries that do not allow donation from deceased donors for cultural, social, or religious reasons.
Hyperperfusion plays an important role in liver regeneration after LDLT, but it may induce injury in the graft . After the reperfusion of a partial graft, there is a significant increase in the portal flow, but Hepatic artery flow remains constant . Excessive portal vein flow may induce injuries in grafts and may contribute to poor graft function.
For satisfactory graft function early after LT, the portal vein pressure (PVP) value after reperfusion should be <15 mm Hg. PVP is the most important hemodynamic factor influencing the functional status of the liver and graft regeneration after LT.
The use of Splenic Artery Ligation (SAL) as a simple and safe method to modulate portal flow has been reported .
The investigators will evaluate that Splenic artery ligation in living donor liver transplantation for patients with Portal hypertension is feasible and efficient technique to improve early graft function and to decrease morbidity and hospital stay and improve outcomes .
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients undergoing Living Donor Liver Transplantation(LDLT) accepted according to hospital protocol.
- •Patients who have Portal Venous Pressure (PVP) > 15 mm Hg after reperfusion .
排除标准
- •Patients who have Portal Venous Pressure (PVP) > 15 mm Hg after reperfusion.
- •Patients who had splenectomy.
- •Patients who have splenic artery aneurysm.
结局指标
主要结局
Incidence of early graft dysfunction
时间窗: first postoperative month
Number of patients who develop early graft dysfunction in each group
Time to normalisation of INR
时间窗: first postoperative month
time to normalisation of INR (in days)
Time to normalisation of bilirubin
时间窗: first postoperative month
time to normalisation of bilirubin (in days)
Time to normalisation of ascites output
时间窗: first postoperative month
time to normalisation of ascites output (in days)
次要结局
- Mortality(first postoperative month)
- ICU stay(first postoperative month)
- Morbidity(first postoperative month)
- Total hospital stay(first postoperative month)
研究者
Abdallah Rashad Abdelaziz
Principal investigator
Assiut University