Impact of Splenic Artery Ligation in LDLT for Patients With Portal Hypertension

Assiut University

Status: Unknown

Conditions: Living Donor Liver Transplantation

Treatments: Procedure: No intervention; Procedure: splenic artery ligation

Study type: Interventional

Funder types: Other

Identifiers

NCT04988100

GIM in LDLT

Details and patient eligibility

About

In this study, the investigators aim to prove that performing splenic artery ligation in living donor liver transplantation for patients with portal hypertension is beneficial for early graft function postoperatively. The investigators will be analyzing trend of LFT's (liver function tests) after surgery, time for normalization of bilirubin, INR (international normalised ratio) and decrease in ascites, morbidity, mortality, ICU (intensive care unit) and total hospital stay.

Full description

Liver transplantation (LT) is the principal treatment for end-stage liver diseases and selected cases of liver neoplasms . Living donor liver transplantation (LDLT) serves as a sole source of liver graft in some countries that do not allow donation from deceased donors for cultural, social, or religious reasons.

Hyperperfusion plays an important role in liver regeneration after LDLT, but it may induce injury in the graft . After the reperfusion of a partial graft, there is a significant increase in the portal flow, but Hepatic artery flow remains constant . Excessive portal vein flow may induce injuries in grafts and may contribute to poor graft function.

For satisfactory graft function early after LT, the portal vein pressure (PVP) value after reperfusion should be <15 mm Hg. PVP is the most important hemodynamic factor influencing the functional status of the liver and graft regeneration after LT.

The use of Splenic Artery Ligation (SAL) as a simple and safe method to modulate portal flow has been reported .

The investigators will evaluate that Splenic artery ligation in living donor liver transplantation for patients with Portal hypertension is feasible and efficient technique to improve early graft function and to decrease morbidity and hospital stay and improve outcomes .

Enrollment: 30 estimated patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients undergoing Living Donor Liver Transplantation(LDLT) accepted according to hospital protocol.
• Patients who have Portal Venous Pressure (PVP) > 15 mm Hg after reperfusion .

Exclusion criteria

• Patients who have Portal Venous Pressure (PVP) > 15 mm Hg after reperfusion.
• Patients who had splenectomy.
• Patients who have splenic artery aneurysm.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

30 participants in 2 patient groups

Patients who undergo Splenic artery ligation

Experimental group

Description:

If inclusion criteria are met, these group of patients will undergo splenic artery ligation .

Treatment:

Procedure: splenic artery ligation

No splenic artery ligation

Active Comparator group

Description:

If inclusion criteria are met, these group of patients will not undergo splenic artery ligation.

Treatment:

Procedure: No intervention