Incidence of post reperfusion syndrome and factors affecting it in patients undergoing Living donor liver transplantation.

Recruiting

Conditions: Primary biliary cirrhosis,

Registration Number: CTRI/2022/05/042416

Lead Sponsor: Institute of livr and biliary sciences

Brief Summary: Liver transplantation is the most challenging surgeryfor an anaesthetist as severe and rapid haemodynamic changes can occur duringliver transplantation asa result of both the disease process and the surgery.Post-reperfusionsyndrome (PRS) is a serious intraoperative complication of liver transplantations,which typically appears after portal vein declamping andcan be associated with major cardiovascular and metabolic derangements.

There are two definitions of PRS-

Aggarwal1 defined PRS as a decrease in mean arterial pressure(MAP) of more than 30% from the baseline value, for at least 1 min, occurringduring the first 5 min after reperfusion of the liver graft.

Hilmi et al2 hasstratified PRS into mild and moderate.

MildPRS-defined by a decrease of MAP and/or heart rate (HR) not reaching 30% ofbaseline value, lasting for < 5 min, and responsive to an intravenous bolusdose of Calcium Chloride (1 g) and/or epinephrine (â‰¤100 mcg) without the needto start a continuous infusion of vasopressors.

Significant PRS,defined by greater hemodynamic instability, a drop in MAP/HR exceeding 30% ofbaseline, asystole or hemodynamically significant arrhythmias, or the need tostart the infusion of vasopressors during the intraoperative period.Risk factorassociated with PRS include-Hyperkalemia, Hypothermia immediately afterreperfusion, Advanced age of donors, Graft Weight, Volume of transfused bloodcomponents, Cold ischaemia time , Warm ischaemia time, MELD score, Hypocalcemia,Hypovolemia

Patients undergoingliver transplant frequently display considerable physiological changes duringthe procedures as a result of both the disease process and the surgery. Haemodynamicchanges occurring during liver transplantation are severe and rapid.

As per our literature search, there are no original studies evaluating post-reperfusionsyndrome in Living donor liver transplantation. Previous studies have includedonly the deceased donor patients and the classical definition by Aggarwal andhilmi have also been defined for the Deceased donor patients. Hence this study aimed to study the incidenceand factors which can affect PRS during living donor liver transplantation.

Detailed Description: Not available

Recruitment & Eligibility

Status: Open to Recruitment

Sex: All

Target Recruitment: 100

Inclusion Criteria

All patients undergoing living donor liver transplant 2.

Exclusion Criteria

Patient refusal Patients undergoing double transplant Age <18yrs Acute liver failure patient.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Incidence of post reperfusion syndrome in living donor liver transplant patients and factors which can predict it.	Intraoperatively during reperfusion.

Secondary Outcome Measures

Name	Time	Method
To study hemodynamic changes occuring immediately after release of portal vein clamp and factors affecting reperfusion syndrome.	during reperfusion.

Trial Locations

Locations (1): Institute of liver and biliary sciences.
🇮🇳
South, DELHI, India
Institute of liver and biliary sciences.
🇮🇳South, DELHI, India
Nidhi Srivastava
Principal investigator
9451665199
nidhi.capricon@gmail.com