Post-reperfusion syndrome and ischemia-reperfusion insult are a common well-known complication in liver transplantation. Several trials investigated variables that my contribute to the generation of these two complications for reducing their incidence and magnitude. The investigators will investigate the effect of acute conditioning of the recipients circulation to the vasoactive mediators in the graft as well as the congested intestine through intermittent purging of graft contents into the patient's systemic circulation in living donor liver transplantation.
Patients are subjected to living donor liver transplantation. In this type of grafts, cold ischemia time is minimal and the graft contents of preservative solution are less than cadaveric grafts. The investigators in the current research use HTC as a preservative solution. These factors justified the possibility of purging the graft and portal blood contents into the patient systemic circulation. The exposure to these fluids in this trial will be in an intermittent manner: the portal vein will be declamped for 5 seconds followed by 30 seconds of portal clamping. This will be repeated twice. The primary outcome objective in this trial will be the incidence of post-reperfusion syndrome. Secondary objectives include the severity of PRS, the incidence and severity of ischemia-reperfusion injury, graft and patient's survival.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
80
complete and uninterrupted purge
intermittent portal purge
Liver transplantation program - Gastroenterology surgical center
Al Mansurah, Dakahlia Governorate, Egypt
RECRUITINGLiver transplantation project - Gastroenterology surgical center - Mansoura university
Al Mansurah, Dakahlia Governorate, Egypt
RECRUITINGGastroenterology surgical center - Mansoura university
Al Mansurah, Dakahlia Governorate, Egypt
Post-reperfusion syndrome
Reduced Mean arterial blood pressure to the predefined value
Time frame: 5 minutes after portal declamping
Graft ischemia reperfusion injury
Pathological assessment of IR injury based on Suzuli score
Time frame: one week post-operative
Severity of post-reperfusion syndrome
% decrease in Mean arterial blood pressure
Time frame: 5 minutes after portal declamping
One month patient mortality
Mortality within one post-operative month
Time frame: one month post-operative
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