This study describes Cefazolin pharmacokinetics variation to target levels during liver transplantation.
Cefazolin is one of the many drugs used in antibiotic prophylaxis during liver transplantation. However there are no study describing its pharmacokinetics during liver transplantation. Due to the severe pharmacokinetics interactions caused by both prior hepatopathy and surgical techniques we suppose that Cefazolin blood levels are very different from those targeted for antibiotic prophylaxis. This study aim to describe pharmacokinetics of Cefazolin during liver transplantation in order to adapt antibiotic prophylaxis strategy in case of unadapted measured levels.
Study Type
OBSERVATIONAL
Blood samples
Surgical intensive care unit, University Hospital, Tours
Tours, France
Cefazolin blood concentration
Cefazolin blood concentration will be measured at the moment of surgical incision and every hour until end of surgery
Time frame: Baseline up to 10 hours
Assess correlations between Cefazolin blood concentration and CHILD-PUGH score
Patient's CHILD-PUGH score before transplantation
Time frame: baseline
Assess correlations between Cefazolin blood concentration and MELD score
Patient's MELD score before transplantation
Time frame: baseline
Assess correlations between Cefazolin blood concentration and Cirrhosis etiology
Cause of cirrhosis
Time frame: baseline
Assess correlations between Cefazolin blood concentration and Transplantation indication
Cause leading to transplantation
Time frame: baseline
Assess correlations between Cefazolin blood concentration and Transjugular intrahepatic portosystemic shunt (TIPS)
Medical history of TIPS
Time frame: baseline
Assess correlations between Cefazolin blood concentration and Creatinine
Creatinine levels will be measured before transplantation
Time frame: baseline
Assess correlations between Cefazolin blood concentration and Hemodialysis
Patient needing hemodialysis before liver transplantation
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Time frame: baseline
Assess correlations between Cefazolin blood concentration and Albumin
Albumin levels will be measured before transplantation
Time frame: baseline
Assess correlations between Cefazolin blood concentration and Surgery duration
Time of surgical incision and end of the surgery will be noted
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Portal vein clamping time
Time of portal vein clamping and declamping during realization of vascular anastomosis will be noted
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Ascitis
Volume of ascitis drained at the beginning of surgery
Time frame: Baseline
Assess correlations between Cefazolin blood concentration and Urine output
Volume of urine output during surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Blood loss
Blood loss quantification will be done throughout surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Red cell transfusion unit
The number of red cell units transfused during transplantation will be counted at the end of surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Platelet transfusion unit
The number of platelet units transfused during transplantation will be counted at the end of surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Plasma transfusion unit
The number of plasma units transfused during transplantation will be counted at the end of surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Intraoperative blood salvage
Intraoperative blood salvage transfusion volume during surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Crystalloid infusion
Assess correlations between Cefazolin blood concentration and Volume of crystalloid infusion during surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Colloid infusion
Volume of colloid infusion during surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Basal cardiac index
Cardiac index value at the beginning of surgery
Time frame: Baseline
Assess correlations between Cefazolin blood concentration and Minimal cardiac index
Minimal index value during surgery
Time frame: End of surgery
Assess correlations between Cefazolin blood concentration and Surgical site infection
Number of patient with surgical site infection in the 28 days post-surgery
Time frame: Day 28