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Liver Transplantation clinical trials

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NCT ID: NCT03441035 Recruiting - Clinical trials for Liver Transplant; Complications

Albumin Mass Balance in Liver Transplantation

Start date: March 27, 2018
Phase:
Study type: Observational

This clinical observational cohort study assess the loss of albumin from blood circulation during and after liver transplantation by mass balance of albumin. The overall assumption of this method is that if albumin is more diluted than hemoglobin, it must have left the plasma, presumably into the interstitial space. Predictors of albumin leakage will be assessed, including biomarkers of inflammation and of endothelial damage and dysfunction. The sub cohorts children and patients with complications, defined as prolonged postoperative treatment in the intensive care unit, respectively, will be focused in separate publications.

NCT ID: NCT03374579 Recruiting - Clinical trials for Liver Transplantation

co2 Gap and co2/o2 Ratio in Liver Transplant Patients

co2gap
Start date: June 12, 2017
Phase: N/A
Study type: Interventional

finding surrogate to co to trace the effect of preload challenge would make the test more applicable without the need of advanced hemodynamic monitors,suggested that co2 gap can be used to detect FR after mini fluid challenge and fluid bolts .

NCT ID: NCT03363646 Recruiting - Sepsis Clinical Trials

Italian National Study on the Critically Ill Liver Transplant Patient With an Infection

INFE-OLT
Start date: July 1, 2018
Phase:
Study type: Observational

Despite major advances, infections remain one of the major causes of morbidity and mortality in patients undergoing orthotopic liver transplantation (OLT). Furthermore, data on the epidemiology, severity, and type of post-OLT infections nowadays available come from dated, monocentric, retrospective series. Finally, there is no available data focused on the critical OLT patient admitted to the Intensive Care Unit (ICU). Therefore this study was conceived (1) to describe incidence, severity, epidemiology and outcomes of infections recorded in OLT patients in the ICU (first or re-admission ); (2) to identify possible risk factors and (3) to report the type of the involved microorganism with their antibiotic sensitivity pattern

NCT ID: NCT03222102 Recruiting - Clinical trials for Liver Transplantation

Ventral Hernia Prevention After Liver Transplantation

Start date: November 30, 2017
Phase: N/A
Study type: Interventional

This study aims to evaluate if the risk of developing ventral hernia after liver transplantation can be reduced through the prophylactic implantation of a synthetic, fully resorbable mesh "Phasix" in the course of liver transplantation. Patients will be randomized in a 1:1 ratio to receive either Phasix mesh or standard surgery without the use of Phasix. Ultra-sound examinations of the wound area will be performed 14 days, 3, 6 and 12 months after liver transplantation. Furthermore, presence of infections, seroma, pain and other problems in the wound area will be assessed.

NCT ID: NCT03216447 Recruiting - Clinical trials for Liver Transplantation

A Study of Patient Adherence and Convenience to Immunosuppressive Agents in Newly Liver Transplant

Start date: November 23, 2017
Phase: Phase 4
Study type: Interventional

A study of patient adherence and convenience to immunosuppressive agents in newly liver transplant recipients - a prospective, multi-center, open-labeled, randomized clinical trial for comparison between once-daily early conversion and twice-daily tacrolimus formulation.

NCT ID: NCT03176433 Recruiting - Clinical trials for Liver Transplantation

Post Static Cold Storage Normothermic Machine Liver Perfusion

Start date: May 1, 2017
Phase: Phase 1/Phase 2
Study type: Interventional

The aim of this study is to assess the safety and feasibility of a short period of cold storage prior to normothermic machine perfusion in adult liver transplantation.

NCT ID: NCT03152890 Recruiting - Clinical trials for Liver Transplantation

Insulin Therapy for Postreperfusion Hyperglycemia

INS_LTPL
Start date: May 15, 2017
Phase: Phase 4
Study type: Interventional

Glycemic control during liver transplantation is challenging especially after reperfusion of the liver graft. Insulin dose to treat postreperfusion hyperglycemia is retrospectively analyzed using historical data. The proposed dose then is prospectively applied to the patients to assess the adequacy of the insulin dose.

NCT ID: NCT03102359 Recruiting - Clinical trials for Liver Transplant; Complications

Brain Protection Effect of Selective Head Cooling and Dexmedetomidine in Patients Undergoing Liver Transplantation

Start date: April 5, 2017
Phase: Phase 2
Study type: Interventional

The investigators investigated in the present study whether selective head cooling and dexmedetomidine has an effect on cerebral oxygenation during liver transplantation and has cerebral protective effect in patients undergoing liver transplantation.

NCT ID: NCT03098043 Recruiting - Clinical trials for Liver Transplantation

Post-Static Cold Storage Hypothermic Oxygenated Perfusion in Bergamo Liver Transplant Program

Start date: November 5, 2017
Phase:
Study type: Observational

In light of the widespread organ shortage, dynamic preservation by means of Machine Perfusion (MP) has been proposed as a strategy to increase the pool of suitable grafts for liver transplantation. Reproducing more physiological conditions than traditional Static Cold Storage (SCS), MP may allow a better preservation and evaluation and perhaps even the resuscitation of high risk grafts. As a consequence, unnecessary discard of organs could be avoided and quality and safety of transplantation could be improved as well. Hypothermic MP (HMP) seems to reduce ischemia-reperfusion injury. In fact, hypothermia slows down the metabolic rate and the oxygenation of the perfusate leads to re-synthesis of Adenosine TriPhosphate (ATP), which results in the restoration of cellular energy. Four series about the use of HMP in the clinical setting has been published so far. They all report acceptable outcomes after transplantation of human liver grafts from extended criteria Brain Dead Donors (BDD) and from Donation after Circulatory Death (DCD) donors preserved by HMP, thus proving its feasibility and safety. The efficacy of HMP, instead, is still under investigation in a phase II randomized trial. This is an observational, prospective, monocentric study aiming at verifying the feasibility and safety of post-SCS Hypothermic Oxygenated PErfusion (HOPE) in the setting of our liver transplant program. Extended criteria grafts from BDD and grafts from DCD donors will be preserved by post-SCS HOPE prior to transplantation. The recipients of these grafts will be followed-up for at least 1 year.

NCT ID: NCT03064685 Recruiting - Clinical trials for Liver Transplant Abscess

Risk Factors and Outcomes of Pyogenic Liver Abscess in Adult Liver Recipients: A Match Case Control Study

Start date: November 22, 2016
Phase: N/A
Study type: Observational

Objective: the aim of this study is to identify risk factors associated with the development of pyogenic liver abscesses (PLA) in adult liver recipients (ALR) and to describe the experience of the Hospital Italiano de Buenos Aires (HIBA) in the diagnosis and therapeutic management of these patients. Background: adult liver recipients differ from the general population with PLA as they exhibit: reconstructed biliary anatomy, recurrent hospitalizations, regular performance status and are subjected to immunosuppression. However, the scientific evidence regarding PLA developed in transplanted organs is still scarce and the management of this disease continues to be based on experience in non-transplanted patients. Methods: between 1996 and 2016, 879 adult patients underwent liver transplantation (LT) at our institution. Patients who developed PLA after LT (cases) and controls are matched according to the time from transplant to abscess in a 1 to 5 relation. The investigators performed a logistic regression model to establish PLA risk factors considering clusters for matched cases and controls. Independent risk factors will be identified using multivariate regression analysis.