End-stage Liver Disease Clinical Trial
The gap between the number of candidates for orthotopic liver transplantation and the
availability of suitable liver grafts has led to a rise in deaths on most waiting lists.
Strategies applied in many centers to minimize this deficit include living donation or split
of a cadaveric organ for two recipients, domino transplantation, and the use of so-called
expanded criteria donors. Alternatively, conditioning of an organ would also allow
protec-tion of the liver upon ischemia-reperfusion injury, possibly decreasing postoperative
liver function and im-proving clinical outcome. The technique of conditioning with the
volatile anesthetic sevoflurane is an easily applicable procedure which could be performed
in any center worldwide.
Data and experience with sevoflurane attenuating ischemic-reperfusion injury in liver
resection lead to the hypothesis of a beneficial effect of volatile anesthetics in liver
transplantation. In this randomized controlled trial, patients will be randomly assigned to
liver transplantation with propofol anesthesia (propofol group) or sevoflurane conditioning
with the volatile anesthetic (sevoflurane group). Primary endpoint is postoperative peak of
the transaminase (AST), secondary endpoints are complications, primary liver graft function,
ICU and hospital stay. We hypothesis that patients with conditioning have an attenuated
increase of transaminases as well as a better outcome.
n/a
Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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