Hepato-duodenal Ligament Occlusion and Classic Technique in Liver Transplant

• Conditions: Liver Transplant
• Interventions: Procedure: Surgical technique surgical occlusion

• Registration Number: NCT04265157
• Lead Sponsor: Assiut University

Brief Summary

Liver transplantation was historically associated with massive blood loss. Many factors have contributed to the decline in bleeding and transfusion in the past two decades including refinement of surgical techniques, anesthetics management and the use of point of care guided goal-directed hemostatic therapies. Increasing awareness of the adverse associations of allogenic transfusion has driven the quest for transfusion-free transplantation. Pre-operative management of preoperative anemia and targeted correction of coagulopathy is done to decrease blood transfusion. Liver transplantation is associated with the potential for massive operative blood loss, which has been recognized as one of the main causes of morbidity and mortality after liver transplantation. Therefore, a fine surgical procedure to reduce intraoperative hemorrhage is necessary for favorable outcomes of liver transplantation.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-01-29
• Status Verified: 2020-02
• Study First Submitted QC: 2020-02-09
• Last Update Submitted: 2020-02-09
• Study First Posted: 2020-02-11
• Last Update Posted: 2020-02-11
• Study Start: 2020-03
• Primary Completion: 2022-03
• Study Completion: 2022-09

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• All patients undergoing Living Donor Liver Transplantation accepted according to hospital protocol
• All patients with liver Cirrhosis who have Porto systemic collaterals based on ct angiography

Exclusion Criteria

• Acute fulminant liver failure

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Early occlusion of hepatoduodenal ligament	Surgical technique surgical occlusion	Early occlusion of hepatoduodenal ligament during mobilization of the liver of the recipient by using portal vein clamp or occlusive temporary bands.
classical occlusion of hepatoduodenal ligament	Surgical technique surgical occlusion	classical occlusion of hepatoduodenal ligament after mobilization of the liver of the recipient immediately before explantation by suing of portal vein clamp

Primary Outcome Measures

Name	Time	Method
The amount of intraoperative blood loss measure by Cubic Cm	2 hours