Reperfusion Syndrome in liver transplant

Recruiting

Lead Sponsor: Center for liver and Biliary Sciences Max Super Speciality Hospital SaketNew DelhiIndia

Brief Summary: **Background:**

Liver transplant (LT) surgeries are associated with major intra-operative hemodynamic changes.

One such major change occurs at the time of reperfusion of the new liver graft, when the newly anastomosed portal vein is unclamped to reperfuse the liver graft inside the recipient. It leads to influx of cold, acidic fluid from the liver graft into the recepientâ€™s circulation which causes a major hemodynamic response. This has been called as postreperfusion syndrome (PRS).

The incidence of PRS in deceased donor liver transplant (DDLT) surgeries is shown to be extremely variable varying between 8 - 50%. Since pro-inflammatory cytokines released from the cadaveric graft as well as the prolonged cold ischemia time due to delays in deceased donor programme contributeto PRS.

We postulate, that the incidence of PRS to be lesser in Living donor liver transplant (LDLT) than in DDLT as in LDLT the quality of graft is optimal. The catecholamine storm of cadaveric donor is avoided.Also, the donor hepatectomy and transplant are simultaneously performed,hence anhepatic and cold ischemia times are reduced.

We wish to document the occurrence of PRS in LDLT at our center.n We also wish to identify the predictors of PRS and the postoperative consequences of PRS on liver recepients.

Recruitment & Eligibility

Inclusion Criteria

All consecutive LT procedures in adult patients in our unit will be enrolled for collection of data.

Exclusion Criteria

1. All Deceased.
donor related transplantation (DDLTs) 2.Liver transplants done in patients with ALF 3.LT for non-cirrhotic liver disease 4.Combined liver/kidney transplantation 5.Re-transplantation 6.All liver recipients identified to have cirrhotic cardiomyopathy, grade 3 Diastolic dysfunction on routine preoperative evaluation. 7.All LT recipients on Inotropes before surgery.

Primary Outcome Measures

Name	Time	Method
To document the incidence of PRS during LDLT and classify severity of PRS	at the end of surgery

Secondary Outcome Measures

Name	Time	Method
1.To identify the predictors of PRS.	On Postoperative Day 30 or at discharge (whichever is first)
2)To examine the postoperative consequences of PRS after LT	On Postoperative Day 30 or at discharge (whichever is first)

Locations (1): Max Super Speciality Hospital, Saket West Block,1st Floor, OT department
🇮🇳
South, DELHI, India
Max Super Speciality Hospital, Saket West Block,1st Floor, OT department
🇮🇳South, DELHI, India
Shweta A Singh
Principal investigator
9810625177
drshwetasingh29@gmail.com