Retrograde Reperfusion Versus Antegrade Liver Transplant Reperfusion

London Health Sciences Centre

Status: Withdrawn

Conditions: Liver Transplant Failure

Treatments: Procedure: Graft reperfusion

Study type: Observational

Funder types: Other

Identifiers

NCT03846089

106793

Details and patient eligibility

About

A retrospective cohort analysis was performed comparing patients that had intra operative antegrade liver reperfusions versus patients that had retrograde liver perfusion.

Full description

A retrospective cohort analysis was performed comparing patients that had intra operative antegrade liver reperfusions versus patients that had retrograde liver perfusion. Antegrade Reperfusion(ATR) group: after completing the caval replacement or piggy-back, for IVC anastomosis, Portal vein (PV) anastomosis was done with a running suture as normal fashion, then it was followed by the removal the clamps, starting by the supra hepatic VC, followed by the PV clamp and finally the infrahepatic VC. It was followed by arterial anastomosis and the biliary anastomosis (duct-to-duct if possible). Retrograde group (RETR): after completing the piggyback the IVC was declamped immediately and retrograde low pressure reperfusion of the graft with low oxygenated venous blood was established. Central venous pressure was intended to be higher than in 8 mmHg to enable appropriate retrograde reperfusion in the transplanted liver. Significant venous backflow via portal vein appears immediately after declamping. Venous bleeding from the liver except portal backflow was stopped immediately after declamping the venous anastomosis, as appropriate. Portal vein anastomosis was performed using running suture. It was followed by arterial anastomosis and the biliary anastomosis (duct-to-duct if possible). The endpoints are patient survival and graft survival at 1, 3,5, 10 years post liver transplantation in both groups. To adjust for a selection bias, we will perform a propensity score analysis.

Sex: All

Ages: 16+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• all liver transplantations between 1 Jan 2002 and 31 Dec 2005

Exclusion criteria

• liver retransplantation
• multiorgan transplantation
• ABO incompatible transplantation

Trial design

0 participants in 2 patient groups

Retrograde reperfusion

Description:

After completion of the inferior vena cava anastomosis, the clamps were removed to allow retrograde reperfusion of the graft.

Treatment:

Procedure: Graft reperfusion

Antegrade reperfusion

Description:

After completion of the inferior vena cava anastomosis, the portal vein anastomosis is completed and then the clamps were removed to allow antegrade reperfusion of the graft.

Treatment:

Procedure: Graft reperfusion