| CTRI Number |
CTRI/2025/01/078931 [Registered on: 17/01/2025] Trial Registered Prospectively |
| Last Modified On: |
17/01/2025 |
| Post Graduate Thesis |
No |
| Type of Trial |
Observational |
|
Type of Study
|
Retrospective observational study |
| Study Design |
Single Arm Study |
|
Public Title of Study
|
Restricted fluid therapy in living donor liver transplant |
|
Scientific Title of Study
|
Intraoperative Fluid Therapy-Finding A Balance: A Single Centre Experience With Restrictive Fluid Therapy In Adult Living Donor Liver Transplant |
| Trial Acronym |
NIL |
|
Secondary IDs if Any
|
| Secondary ID |
Identifier |
| NIL |
NIL |
|
|
Details of Principal Investigator or overall Trial Coordinator (multi-center study)
|
| Name |
Dr Amit Singhal |
| Designation |
Director |
| Affiliation |
BLK Max Superspeciality Hospital |
| Address |
Department of HPB and liver transplant Anesthesia and ciritcal care,
BLK Max Superspeciality Hospital,
Pusa Road
New Delhi DELHI 110005 India |
| Phone |
9891873774 |
| Fax |
|
| Email |
drsinghalamit@gmail.com |
|
Details of Contact Person Scientific Query
|
| Name |
Dr Amit Singhal |
| Designation |
Director |
| Affiliation |
BLK Max Superspeciality Hospital |
| Address |
Department of HPB and liver transplant Anesthesia and ciritcal care,
BLK Max Superspeciality Hospital,
Pusa Road
New Delhi DELHI 110005 India |
| Phone |
9891873774 |
| Fax |
|
| Email |
drsinghalamit@gmail.com |
|
Details of Contact Person Public Query
|
| Name |
Dr Amit Singhal |
| Designation |
Director |
| Affiliation |
BLK Max Superspeciality Hospital |
| Address |
Department of HPB and liver transplant Anesthesia and ciritcal care,
BLK Max Superspeciality Hospital,
Pusa Road
New Delhi DELHI 110005 India |
| Phone |
9891873774 |
| Fax |
|
| Email |
drsinghalamit@gmail.com |
|
|
Source of Monetary or Material Support
|
|
|
Primary Sponsor
|
| Name |
Dr Amit Singhal |
| Address |
HPB and Liver transplant Anesthesia and critical care,
BLK Max Superspeciality Hospital,
New Delhi
110005
|
| Type of Sponsor |
Other [Non funded study] |
|
|
Details of Secondary Sponsor
|
|
|
Countries of Recruitment
|
India |
|
Sites of Study
|
| No of Sites = 1 |
| Name of Principal
Investigator |
Name of Site |
Site Address |
Phone/Fax/Email |
| DR AMIT SINGHAL |
BLK Max Superspeciality Hospital |
Department of HPB and Liver Transplant Anaesthesia and critical care
Second floor,
Organ Transplant ICU New Delhi DELHI |
09891873774
drsinghalamit@gmail.com |
|
|
Details of Ethics Committee
|
| No of Ethics Committees= 1 |
| Name of Committee |
Approval Status |
| INSTITUTIONAL ETHICS COMMITTEE DEPARTMENT OF ACADEMIC AFFAIRS RESEARCH & CONTINUING EDUCATION |
Approved |
|
|
Regulatory Clearance Status from DCGI
|
|
|
Health Condition / Problems Studied
|
| Health Type |
Condition |
| Patients |
(1) ICD-10 Condition: K746||Other and unspecified cirrhosis ofliver, (2) ICD-10 Condition: K703||Alcoholic cirrhosis of liver, |
|
|
Intervention / Comparator Agent
|
| Type |
Name |
Details |
| Intervention |
NIL |
NIL |
|
|
Inclusion Criteria
|
| Age From |
18.00 Year(s) |
| Age To |
75.00 Year(s) |
| Gender |
Both |
| Details |
All patients over 18years of age undergoing adult living donor liver transplant from December 2022 to November 2023 will be enrolled in the study |
|
| ExclusionCriteria |
| Details |
- Patients less than 18years of age.
- Patients with H/O recent (less than one week) Hepatorenal syndrome/Acute Kidney Injury
- Patients with known H/O chronic kidney disease
- Patients with Hepatopulmonary syndrome/Portopulmonary Hypertension
- Combined procedure with liver transplant.
- H/O hepatic encephalopathy (Grade 2 or more at the time of transplant)
- Patients with acute liver failure.
INTRAOPERATIVE-
- Patients requiring intraoperative continuous renal replacement therapy
- Patients with incomplete data
POSTOPERATIVE
- Patient requiring mechanical ventilation for graft dysfunction or neurological complications.
- Patient requiring mechanical ventilation for renal replacement therapy |
|
|
Method of Generating Random Sequence
|
Not Applicable |
|
Method of Concealment
|
Not Applicable |
|
Blinding/Masking
|
Not Applicable |
|
Primary Outcome
|
| Outcome |
TimePoints |
•Evaluate our rate of early extubation (on-table extubation, extubated within 4hours postoperatively) after living donor liver transplant, mean duration of mechanical ventilation, pulmonary complications such as pulmonary edema , pleural effusion requiring drainage within 72 hours postoperatively.
•Incidence of Acute kidney injury within 72 hours postoperatively. Need for renal replacement therapy. |
72 hours |
|
|
Secondary Outcome
|
| Outcome |
TimePoints |
| Intraoperative need for packed red blood cells, vasopressor requirement (noradrenaline-mcg/kg/min and total vasopressin units) and rate of vascular complications (hepatic artery thrombosis) |
Intraoperative period |
|
|
Target Sample Size
|
Total Sample Size="200" Sample Size from India="200"
Final Enrollment numbers achieved (Total)= "100"
Final Enrollment numbers achieved (India)="100" |
|
Phase of Trial
|
N/A |
|
Date of First Enrollment (India)
|
28/01/2025 |
| Date of Study Completion (India) |
Date Missing |
| Date of First Enrollment (Global) |
Date Missing |
| Date of Study Completion (Global) |
05/02/2025 |
|
Estimated Duration of Trial
|
Years="0" Months="0" Days="30" |
|
Recruitment Status of Trial (Global)
|
Not Applicable |
| Recruitment Status of Trial (India) |
Completed |
|
Publication Details
|
N/A |
|
Individual Participant Data (IPD) Sharing Statement
|
Will individual participant data (IPD) be shared publicly (including data dictionaries)?
Response - NO
|
|
Brief Summary
|
We practice weight based restrictive fluid strategy with maintenance therapy at 4ml/kg/h (2ml/kg/h crystalloids + 2ml/kg/h 4%albumin solution) and fluid boluses guided by goal directed parameters.We will retrospectively analyze our data of patients undergoing adult living donor liver transplant in one year period and determine the average fluid requirement and its effect on pulmonary outcomes and incidence of postoperative acute kidney injury. Secondary outcomes will be intraoperative blood and vasopressor requirement(noradrenaline) and vascular complication rate.We hypothesise that our strategy of continuous maintenance therapy with intermittent fluid boluses improves pulmonary outcomes with no increased risk of acute kidney injury. The statistical analysis will be done with the Graph Pad Prism. |