Ascorbic Acid to Prevent Postreperfusion Syndrome in Liver Transplantation

NCT ID: NCT05754242

Last Updated: 2023-03-03

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

PHASE2

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-17

Study Completion Date

2023-07-30

Brief Summary

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The goal of this clinical trial is to test the efficacy of intravenous ascorbic acid in preventing the postreperfusion syndrome in liver transplantation. The main questions it aims to answer are:

* Can intravenous ascorbic acid prevent postreperfusion syndrome in liver transplantation ?
* Can ascorbic acid decrease the incidence of liver graft dysfunction after liver transplantation?
* Can ascorbic acid decreased the incidence of postoperative complications after liver transplantation ?

Participants will receive 1.5 g of intravenous ascorbic acid diluted in 100 ml of saline or 100 ml of saline alone, during the anhepatic phase of liver transplantation before reperfusion of the new graft.

Researchers will compared the incidence of postreperfusion syndrome in both groups.

Detailed Description

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Researches will compared:

* Incidence of postreperfusion syndrome in liver transplantation
* Changes in interleukin values and other inflammatory markers before and after transplantation
* Incidence of liver graft dysfunction between groups
* Incidence of acute renal failure and other complications between groups

Conditions

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Liver Transplantation Postreperfusion Syndrome Ascorbic Acid

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Ascorbic acid

1.5 gr of ascorbic acid diluted in 100 ml of 0.9% saline solution will be administered intravenously during the anhepatic phase of liver transplantation

Group Type EXPERIMENTAL

Ascorbic acid

Intervention Type DRUG

1.5 gr of ascorbic acid

Saline solution

100 ml of 0.9% saline solution will be administered during the anhepatic phase of liver transplantation

Group Type PLACEBO_COMPARATOR

0.9% Saline solution

Intervention Type DRUG

100 ml of 0.9% saline solution

Interventions

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Ascorbic acid

1.5 gr of ascorbic acid

Intervention Type DRUG

0.9% Saline solution

100 ml of 0.9% saline solution

Intervention Type DRUG

Other Intervention Names

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Vitamin C Saline

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing liver transplantation

Exclusion Criteria

* Pregnancy
* Allergy to ascorbic acid
* Nephrolithiasis
* Glucose-6-phosphate dehydrogenase (G6PD) deficiency
* Hyperoxaluria
* Hyperuricemia
* Haemochromatosis
* Sickle cell anemia
* Serum Creatinine \> 1.2 mg/dl in women and 1.3 mg/dl in men
* Split liver graft
* Acute liver failure
* Living donor liver transplantation
* Controlled donor asystolia
* Treatment with: indinavir, Vitamin B12, Cyclosporine, iron, deferoxamine, disulfiram
Minimum Eligible Age

18 Years

Maximum Eligible Age

67 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Universitario Ramon y Cajal

OTHER

Sponsor Role lead

Responsible Party

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Luis Gajate Martín

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Luis Gajate, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitario Ramón y Cajal

Locations

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Hospital Universitario RAmon y Cajal

Madrid, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Luis Gajate, MD PhD

Role: CONTACT

+34913368269

Ines de la Hoz, MD

Role: CONTACT

+34913368269

Facility Contacts

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Luis Gajate, MD PhD

Role: primary

+34913368269

Ines de la Hoz, MD

Role: backup

+34913368269

References

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Aggarwal S, Kang Y, Freeman JA, Fortunato FL, Pinsky MR. Postreperfusion syndrome: cardiovascular collapse following hepatic reperfusion during liver transplantation. Transplant Proc. 1987 Aug;19(4 Suppl 3):54-5. No abstract available.

Reference Type BACKGROUND
PMID: 3303534 (View on PubMed)

Siniscalchi A, Dante A, Spedicato S, Riganello L, Zanoni A, Cimatti M, Pierucci E, Bernardi E, Miklosova Z, Moretti C, Faenza S. Hyperdynamic circulation in acute liver failure: reperfusion syndrome and outcome following liver transplantation. Transplant Proc. 2010 May;42(4):1197-9. doi: 10.1016/j.transproceed.2010.03.097.

Reference Type BACKGROUND
PMID: 20534260 (View on PubMed)

Paugam-Burtz C, Kavafyan J, Merckx P, Dahmani S, Sommacale D, Ramsay M, Belghiti J, Mantz J. Postreperfusion syndrome during liver transplantation for cirrhosis: outcome and predictors. Liver Transpl. 2009 May;15(5):522-9. doi: 10.1002/lt.21730.

Reference Type BACKGROUND
PMID: 19399736 (View on PubMed)

Blanot S, Gillon MC, Lopez I, Ecoffey C. Circulating endotoxins and postreperfusion syndrome during orthotopic liver transplantation. Transplantation. 1995 Jul 15;60(1):103-6. doi: 10.1097/00007890-199507150-00019. No abstract available.

Reference Type BACKGROUND
PMID: 7624932 (View on PubMed)

Bezinover D, Kadry Z, McCullough P, McQuillan PM, Uemura T, Welker K, Mastro AM, Janicki PK. Release of cytokines and hemodynamic instability during the reperfusion of a liver graft. Liver Transpl. 2011 Mar;17(3):324-30. doi: 10.1002/lt.22227.

Reference Type BACKGROUND
PMID: 21384515 (View on PubMed)

Blanot S, Gillon MC, Ecoffey C, Lopez I. Circulating endotoxins during orthotopic liver transplantation and post-reperfusion syndrome. Lancet. 1993 Oct 2;342(8875):859-60. doi: 10.1016/0140-6736(93)92715-6. No abstract available.

Reference Type BACKGROUND
PMID: 8104281 (View on PubMed)

Ishine N, Yagi T, Ishikawa T, Sasaki H, Nakagawa K, Tanaka N. Hemodynamic analysis of post-reperfusion syndrome and the effect of preventing this syndrome using thromboxane A2 synthetase inhibitor (OKY-046) in swine liver transplantation. Transplant Proc. 1997 Feb-Mar;29(1-2):378-81. doi: 10.1016/s0041-1345(96)00127-3. No abstract available.

Reference Type BACKGROUND
PMID: 9123045 (View on PubMed)

Girn HR, Ahilathirunayagam S, Mavor AI, Homer-Vanniasinkam S. Reperfusion syndrome: cellular mechanisms of microvascular dysfunction and potential therapeutic strategies. Vasc Endovascular Surg. 2007 Aug-Sep;41(4):277-93. doi: 10.1177/1538574407304510.

Reference Type BACKGROUND
PMID: 17704330 (View on PubMed)

Wilson JX. Mechanism of action of vitamin C in sepsis: ascorbate modulates redox signaling in endothelium. Biofactors. 2009 Jan-Feb;35(1):5-13. doi: 10.1002/biof.7.

Reference Type BACKGROUND
PMID: 19319840 (View on PubMed)

Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Arch Surg. 2000 Mar;135(3):326-31. doi: 10.1001/archsurg.135.3.326.

Reference Type BACKGROUND
PMID: 10722036 (View on PubMed)

Zabet MH, Mohammadi M, Ramezani M, Khalili H. Effect of high-dose Ascorbic acid on vasopressor's requirement in septic shock. J Res Pharm Pract. 2016 Apr-Jun;5(2):94-100. doi: 10.4103/2279-042X.179569.

Reference Type BACKGROUND
PMID: 27162802 (View on PubMed)

Fowler AA 3rd, Syed AA, Knowlson S, Sculthorpe R, Farthing D, DeWilde C, Farthing CA, Larus TL, Martin E, Brophy DF, Gupta S; Medical Respiratory Intensive Care Unit Nursing; Fisher BJ, Natarajan R. Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis. J Transl Med. 2014 Jan 31;12:32. doi: 10.1186/1479-5876-12-32.

Reference Type BACKGROUND
PMID: 24484547 (View on PubMed)

Gajate L, de la Hoz I, Espino M, Martin Gonzalez MDC, Fernandez Martin C, Martin-Grande A, Parise Roux D, Pastor O, Villahoz J, Rodriguez-Gandia MA, Nuno Vazquez J. Intravenous Ascorbic Acid for the Prevention of Postreperfusion Syndrome in Orthotopic Liver Transplantation: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2023 Dec 15;12:e50091. doi: 10.2196/50091.

Reference Type DERIVED
PMID: 38100226 (View on PubMed)

Other Identifiers

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EC 20/606

Identifier Type: -

Identifier Source: org_study_id

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