Liver Transplantation Clinical Trial
Official title:
A Randomized Study of Effect of Preimplantation Portal Vein and Hepatic Artery Liver Flushing With Tacrolimus on Ischemia-reperfusion Injury, Allograft Dysfunction and Liver Histology
The purpose of this study is to determine whether the Tacrolimus added to histidine-tryptophan-ketoglutarate (HTK) solution given through intraportal and intraarterial infusion during back-table procedure is capable of reducing the degree of early allograft liver dysfunction, as assessed by postoperative levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), during first 7 postoperative days and by serum and histochemical markers of liver injury and inflammation.
Early allograft liver dysfunction remains a significant complication of cadaveric liver
transplantation with resource consuming and costly treatment, increased risk of multiorgan
failure and 6-months mortality.
Ischemic reperfusion injury (IRI) is a main reason for early allograft liver dysfunction.
Inflammatory response to brain death in donor can precipitate the extent of dysfunction
after reperfusion in recipient (1). Clear inflammatory pathways in response to IRI have been
reported to be associated with early allograft liver dysfunction (2,3). It was shown that ex
vivo intraportal tacrolimus perfusion suppressed inflammation and immune response in the
transplanted liver on a genome-wide basis (4).
We hypothesize that Tacrolimus added to HTK solution given through intraportal and
intraarterial back-table infusion is capable of reducing the degree of early allograft liver
dysfunction, as assessed by incidence of postreperfusion hyperfibrinolysis, postoperative
levels of AST,ALT, during 1-7 postoperative days as well as serum and histochemical markers
of liver injury and inflammation compared to no intraportal and intraarterial back-table
infusion.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Caregiver, Outcomes Assessor), Primary Purpose: Prevention
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