Hepatic Encephalopathy Clinical Trial
Official title:
Early Postoperative Continuous Renal Replacement Therapy After Liver Transplantation in Acute-on-chronic Liver Failure Patients With Overt Hepatic Encephalopathy
Pretransplant hepatoencephalopathy (HE) markedly impacts recipient outcomes after liver transplantation. Intraoperative CRRT showed benefits but feasibility was much concerned. This study aims to observe the effect on consciousness recovery when initiating CRRT early in the post-transplant period in recipients with ACLF and overt HE.
Hepatoencephalopathy (HE) is a common severe decompensation in end stage liver diseases and
resulted to the need of liver transplantation (LT). Pretransplant HE markedly impacts
recipient outcomes after liver transplantation. HE in acute on chronic liver failure (ACLF)
is categorized to type C HE. Hyperammonemia and systemic inflammation have been reported to
contribute its development. Continuous renal replacement therapy (CRRT) has been shown great
benefits in ACLF patients with HE. Intraoperative CRRT in LT also showed benefits but
feasibility was much concerned. Our preliminary retrospective data showed that early CRRT
(eCRRT) after LT reduced consciousness recovery time, ventilation days and post-transplant
infection rate.
This open label, parallel randomized trial will observe the effect on consciousness recovery
when initiating CRRT early (eCRRT) in the post-transplant period in recipients with ACLF and
overt HE.
The CRRT safety and ventilation days, infection, mortality and ICU stay will also be
measured.
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