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During liver transplantation, due to the complexity of the operation and abnormal coagulation function, there may be a large amount of bleeding and corresponding blood transfusion. Excessive blood transfusion will increase pulmonary complications and affect the prognosis. Infusion management to reduce bleeding is a very important issue in liver transplant surgery. Restrictive infusion management can effectively reduce the amount of bleeding in liver transplantation, but it remains unclear whether it will cause sequelae in other major organs.
The investigators plan to study different infusion goals and strategies in liver transplant surgery using a randomized group model, using the PiCCO (Pulse Contour Cardiac Output) cardiopulmonary volume monitor, and setting the stroke volume variation (SVV) as the macroscopic circulation.The purpose of this study was to divide it into restrictive and liberal groups to explore the impact on liver transplantation bleeding volume and inflammatory response as well as postoperative lung and renal function, and to collect statistics on clinical care and postoperative sequelae (pulmonary liver, renal function impairment, etc.) in order to develop the most appropriate infusion management strategy in liver transplantation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Liberal group | Active Comparator | stroke volume variation < 10% |
|
| restrictive group | Experimental | stroke volume variation < 18% |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Liberal group | Other | Fluid challage to keep stroke volume variation < 10% |
| |
| Measure | Description | Time Frame |
|---|---|---|
| blood loss intraoperatively | blood loss intraoperatively in liver transplant | during the operation |
| Measure | Description | Time Frame |
|---|---|---|
| Lung injury biomarker | serum Clara Cell Protein (CC16) | from biginning of the operation to postoprative day 1 |
| Kidney injury biomarker | serum Neutrophil Gelatinase Associated Lipocalins (NGALs) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kuang-Cheng Chan, M.D.,PhD. | Contact | +886-2-23123456 | 262158 | jkjchan@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Kuang-Cheng Chan, M.D.,PhD. | Department of Anesthesiology, National Taiwan University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Taiwan University Hospital | Recruiting | Taipei | Taiwan |
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| ID | Term |
|---|---|
| D006470 | Hemorrhage |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| restrictive group |
| Other |
Fluid challage to keep stroke volume variation < 18% |
|
| from biginning of the operation to postoprative day 1 |
| Influammatory reponses | IL-6 | from biginning of the operation to postoprative day 1 |