Safety of Iodinated Contrast in Liver Transplant Candidates With Decreased Renal Function Undergoing Coronary CT Angiography

NCT ID: NCT03806725

Last Updated: 2022-01-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Study Classification

OBSERVATIONAL

Study Start Date

2020-06-01

Study Completion Date

2022-03-30

Brief Summary

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This study evaluates the safety of iodinated contrast medium administered to liver transplant candidates with decreased renal function undergoing coronary CT angiography. Incidence of post-contrast acute kidney injury in liver transplant candidates with decreased renal function and normal renal function will be compared.

Detailed Description

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Low osmolar non-ionic contrast medium (LOCM) is routinely used for contrast-enhanced computed tomography (CT) including coronary computed tomography angiography (CCTA).

This study evaluates the effect of LOCM on liver transplant candidates with normal and decreased renal function undergoing CCTA. Incidence of post-contrast acute kidney injury (PC-AKI) will be compared between the two groups before and after contrast medium exposure.

LOCM is a potential cause of PC-AKI, especially in vulnerable population with decreased renal function. According to the American College of Radiology (ACR) manual on contrast media, however, many published studies on PC-AKI in the past have been heavily contaminated by bias and conflation. More recent studies do not confirm a high risk of contrast induced nephropathy.

End stage liver disease patients with normal renal function do not seem to be at a higher risk of developing PC-AKI. Only limited data reporting a low incidence of PC-AKI after contrast-enhanced CT in patients with liver cirrhosis and concomitant decreased renal function exists. Proof of low PC-AKI in this specific population would allow to redirect patients from invasive catheterization to CCTA as their cardiac clearance before transplantation. This study will prospectively investigate the incidence of PC-AKI in this specific at-risk population.

Conditions

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Acute Kidney Injury Renal Insufficiency, Chronic Contrast-induced Nephropathy Liver Transplantation Contrast Media

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Liver transplant (LTx) candidates with eGFR>=60

Liver transplant candidates with renal function defined by eGFR above or equal to 60 ml/min/1.73m2, eGFR is determined by Cystatin C measurement.

Intravenous administration of iodinated contrast medium for coronary CT angiography

Intervention Type DIAGNOSTIC_TEST

Administration of iodinated contrast medium for coronary CT angiography

LTx candidates with eGFR<60

Liver transplant candidates with decreased renal function.

Defined by eGFR less than 60 ml/min/1.73m2, eGFR is determined by Cystatin C measurement.

Intravenous administration of iodinated contrast medium for coronary CT angiography

Intervention Type DIAGNOSTIC_TEST

Administration of iodinated contrast medium for coronary CT angiography

Interventions

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Intravenous administration of iodinated contrast medium for coronary CT angiography

Administration of iodinated contrast medium for coronary CT angiography

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

\- Liver transplant candidate, age \> 21 referred for coronary CT angiography, medium-risk patient for coronary artery disease

Exclusion Criteria

* Liver transplant candidates who are at low-risk for coronary artery disease and therefore do not need coronary CT angiography or invasive catheterization
* Liver transplant candidates who are at high-risk for coronary artery disease and are referred directly to invasive catheterization
* Candidates with chronic kidney disease stage 4, with eGFR \<30 ml/min/1.73m2
* Known or suspected allergy to standard iodine contrast medium
Minimum Eligible Age

21 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Dominik Fleischmann, MD

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Stanfor University

Stanford, California, United States

Site Status

Countries

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United States

Other Identifiers

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IRB-45901

Identifier Type: -

Identifier Source: org_study_id

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