Citrate Anticoagulation During MARS Treatment

Status Unknown status

Clinical Trial Summary

The optimal anticoagulation procedure during MARS treatment has not been defined. In various multi-centre trials, such as MARS-RELIEF, anticoagulation procedures are left to the discretion of the treating physician. On the one hand, given the increased risk of bleeding associated with liver failure, high dosage of anticoagulation therapy should be avoided. On the other hand, contact of blood or blood components with the extracorporeal circuit will likely result in coagulation activation or even loss of coagulation factors.

Citrate anticoagulation has gained popularity, especially in hemodialysis patients. It results in a highly effective anticoagulation, exclusively confined to the extracorporeal circulation. Moreover, dependent on the type of dialyser membrane, citrate anticoagulation resulted in reduced activation of other cellular components.

In contrast to hemodialysis patients, experience with citrate anticoagulation during treatment with artificial liver devices is limited. The liver contributes substantially to the metabolism of exogenous citrate. As a result, cirrhotic patients have decreased endogenous citrate clearances. Importantly, blood purification devices contribute substantially to overall citrate clearance, thereby preventing accumulation of citrate. Several centres, including our own, have gained experience with citrate anticoagulation during fractionated plasma separation and adsorption (FPSA), a related liver dialysis device, in the treatment of liver failure patients.

Citrate anticoagulation during MARS treatment has not been studied so far.

Clinical Trial Description

n/a

Study Design

Related Conditions & MeSH terms

Liver Failure

Clinical Trial Details

NCT number	NCT00695617
Study type	Interventional
Source	Universitaire Ziekenhuizen Leuven
Contact	Pieter Evenepoel, MD, PhD
Phone	+32 16 344580
Email	pieter.evenepoel@uz.kuleuven.ac.be
Status	Unknown status
Phase	Phase 2/Phase 3
Start date	July 2008
Completion date	December 2009

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