Hepatic Vein Flow During Orthotopic Liver Transplantation as Predictive Factor for Postoperative Graft Function

Henry Ford Health System97 enrolled

Overview

Hepatic vein flow (HVF) assessment using transesophageal echocardiography (TEE) has a potential to predict postoperative graft function in orthotopic liver transplant (OLT). Investigators will measure HVF using TEE and assess the correlation with postoperative graft function indices such as early allograft dysfunction(EAD), prolonged INR, platelet, and total bilirubin.

During OLT, intraoperative TEE assessment of HVF (systolic and diastolic) were measured, and adjusted with donor graft weight. This index, HVF index, was assessed for correlation with EAD. HVF was calculated with hepatic vein area (cm2) x hepatic vein velocity (ml/s) in systole and diastole during the neohepatic phase. Investigators did ROC analysis to assess the predictive power for EAD, prolonged INR, platelet, and total bilirubin.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Postoperative Graft Function

Interventions

NO internventionOTHER

NO internvention

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: Orthotopic liver transplants which uses TEE intraoperatively Must be Piggy back technique \- Exclusion Criteria: TEE absolute contraindication patient refusal

Locations (1)

HFHS

Detroit, Michigan, United States

Outcomes

Primary Outcomes

EAD

Primary outcome was early allograft dysfunction (EAD), which was defined by the presence of one or more of the following: total bilirubin (t-bil) ≥ 10 mg/dL (171 μmol/L) or, INR ≥ 1.6 on postoperative day 7. and ALT/AST \> 2,000 IU/L Systolic and diastolic hepatic vein flow index was assessed intraoperatively in neohepatic phase in both of EAD and non EAD group, and reported.

Time frame: EAD met at any point within the first 7 days status post OLT

Secondary Outcomes

Acute Rejection

Acute rejection noted with biopsy at any point within 6 to 8 weeks post-transplant

Time frame: Acute rejection noted at any point within 6-8 weeks post transplant

Prolonged (>Seven Days) Time to Normalize Total Bilirubin (TIME T-bil)

Normal total bilirubin \< 1.2 mg/dL

Time frame: postoperative day 7 assessment

Prolonged (>Seven Days) Time to Normalize INR (TIME Inr)

Normal INR \< 1.16

Time frame: postoperative day 7 assessment

Prolonged (>Seven Days) Time to Normalize Platelet Count (TIME Plt).

Normal platelet count \> 140 B/L

Time frame: postoperative day 7 assessment

Data from ClinicalTrials.gov

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