Association Between the Use of Pulmonary Artery Catheter and Clinical Outcomes After Liver Transplantation
- Conditions
- End Stage Liver DIseaseLiver CirrhosisLiver Transplant; ComplicationsLiver Diseases
- Interventions
- Device: Pulmonary artery catheter (Edward Lifesciences, Irvine, California, USA)Device: FloTrac Vigileo system (EV1000 clinical platform, Edward Lifesciences, Irvine, California, USA)
- Registration Number
- NCT05457114
- Lead Sponsor
- Seoul National University Hospital
- Brief Summary
The investigators attempted to evaluate whether the use of PAC is associated with better clinical outcomes after liver transplantation compared with the case without PAC.
- Detailed Description
Pulmonary artery catheter (PAC) has been used for advanced hemodynamic monitoring during liver transplantation. However, recent advances in less invasive monitoring could provide continuous cardiac output monitoring by arterial waveform analysis. Using this technology, stroke volume variation (SVV) is monitored as a preload index. Calculated systemic vascular resistance (SVR) can be monitored if central venous pressure (CVP) is provided. Therefore, this less invasive form of hemodynamic monitoring may replace the PAC. The investigators attempted to evaluate whether the use of PAC is associated with better clinical outcomes after liver transplantation compared with the case without PAC.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 1970
- Adult patients who underwent living or deceased donor liver transplantation at our tertiary care university hospital between 2006 and 2022
- Patients with baseline renal dysfunction
- Missing baseline or outcome variables
- Retransplantation
- Patients who received intraoperative transesophageal echocardiography (TEE) monitoring
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Pulmonary artery catheter group Pulmonary artery catheter (Edward Lifesciences, Irvine, California, USA) Patients who received pulmonary artery catheter insertion and hemodynamic monitoring by PAC-derived parameters Non-pulmonary artery catheter group FloTrac Vigileo system (EV1000 clinical platform, Edward Lifesciences, Irvine, California, USA) Patients who did not received pulmonary artery catheter insertion and were monitored with Flo-Trac FloTrac Vigileo
- Primary Outcome Measures
Name Time Method Number of Participants with acute kidney injury the first 7 postoperative days Acute kidney injury (AKI) was defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria, which was defined according to the greatest change in serum creatinine level during the postoperative seven days (Stage 1: more than 1.5-fold; stage 2: more than 2-fold; stage 3: more than 3-fold increase from baseline level or increase in serum creatinine to ≥ 4.0 mg/dL or the initiation of renal replacement therapy). The most recent serum creatinine level measured before surgery was collected as a baseline value.
Number of Participants with early allograft dysfunction the first 7 postoperative days Early allograft dysfunction (EAD) was defined when one or more of the following are present within the first 7 postoperative days: total bilirubin ≥ 10 mg/dL, prothrombin time: international normalized ratio ≥ 1.6, or aspartate or alanine transaminase \> 2000 IU/L
- Secondary Outcome Measures
Name Time Method In-hospital mortality the first month after admission all-cause mortality during hospitalization
One-year mortality one year after transplantation all-cause mortality during one year after transplantation
Length of intensive care unit (ICU) stay the first month after admission Length of intensive care unit stay after transplantation
Length of hospital stay the first month after admission Length of hospital stay after transplantation
Trial Locations
- Locations (1)
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of