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

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-01

Study Completion Date

2023-10-01

Brief Summary

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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.

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Detailed Description

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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 .

Conditions

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Living Donor Liver Transplantation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Patients who undergo Splenic artery ligation

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

Group Type EXPERIMENTAL

splenic artery ligation

Intervention Type PROCEDURE

Splenic artery will be ligated just after takeoff from coeliac trunk at the level of body of pancreas

No splenic artery ligation

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

Group Type ACTIVE_COMPARATOR

No intervention

Intervention Type PROCEDURE

Splenic artery is not ligated despite the presence of portal hyperperfusion

Interventions

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splenic artery ligation

Splenic artery will be ligated just after takeoff from coeliac trunk at the level of body of pancreas

Intervention Type PROCEDURE

No intervention

Splenic artery is not ligated despite the presence of portal hyperperfusion

Intervention Type PROCEDURE

Eligibility Criteria

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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.

Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No