Perioperative Hemostasis Management in Liver Transplantation

Status: Recruiting
Location: See all (16) locations...
Study Type: Observational
SUMMARY

Liver transplantation (LT) is a surgery with risk of bleeding. Several risk factors have been identified: complex dissection, portal hypertension, history of ascites fluid infections, history of surgical procedures, pre-existing complex hemostatic disorders and those acquired during the procedure. Diffuse bleeding can occur at any time during the 3 phases of surgery: dissection, anhepatic and neohepatic. However, intraoperative bleeding and transfusion requirements remain difficult to predict. Current predictive models are based in particular on preoperative characteristics and do not take into account the course and different phases of the operation. The need for transfusions has largely decreased over the last 20 years, and currently around 20-25% of patients are transfused (transfusion of at least 1 blood product during LT). However, massive transfusion is necessary in 10% of LT. The European Society of Anaesthesiology (ESA) has issued recommendations on the management of severe bleeding during surgery. However, these recommendations are not specific to LT. Moreover, transfusion strategies vary widely from one center to another. The implementation of protocols within teams dedicated to LT has led to a reduction in bleeding and transfusion, with or without the use of viscoelastic testing. Intraoperative bleeding and transfusion requirements, as well as postoperative thromboembolic complications, remain difficult to predict. Predictive models of bleeding risk have been developed, but they are based solely on preoperative characteristics and do not take into account the course and various phases of the operation. In addition, new methods such as Bayesian inference or machine learning have been developed, and seem capable of providing different information from that obtained by conventional models. The overall aim of this prospective multicenter observational study is to investigate the risk factors for bleeding and thrombosis in per- and post-operative LT using different predictive methods, and to describe the management of bleeding and post-operative anticoagulation in metropolitan France.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Patients aged 18 or over

• Liver transplant patient

Locations
Other Locations
France
Chru Minjoz
RECRUITING
Besançon
CHU Estaing
NOT_YET_RECRUITING
Clermont
Hôpital Beaujon
NOT_YET_RECRUITING
Clichy
CHU Grenoble Alpes
NOT_YET_RECRUITING
Grenoble
CHU Claude Huriez
RECRUITING
Lille
Hôpital de la Croix-Rousse
RECRUITING
Lyon
CHU La Timone
NOT_YET_RECRUITING
Marseille
Hôpital St Eloi
NOT_YET_RECRUITING
Montpellier
Hôpital De L'Archet 2
NOT_YET_RECRUITING
Nice
CHU Pitié-Salpêtrière
NOT_YET_RECRUITING
Paris
CHU Haut Levêque
NOT_YET_RECRUITING
Pessac
CHU Pontchaillou
NOT_YET_RECRUITING
Rennes
CHU Hautepierre
NOT_YET_RECRUITING
Strasbourg
CHU Toulouse Rangueil
NOT_YET_RECRUITING
Toulouse
CHU Tours
NOT_YET_RECRUITING
Tours
Hôpital Paul Brousse
RECRUITING
Villejuif
Contact Information
Primary
Emmanuel WEISS, MD
emmanuel.weiss@aphp.fr
+33 1 40 87 58 81
Backup
Stéphanie ROULLET, MD
stephanie.roullet@aphp.fr
+33 1 45 59 32 19
Time Frame
Start Date: 2024-10-17
Estimated Completion Date: 2026-03-01
Participants
Target number of participants: 1200
Treatments
Adults Patients with Liver transplant
No intervention during this observational study. Patient who meet the inclusion criteria will be included
Sponsors
Collaborators: Laboratoire français de Fractionnement et de Biotechnologies
Leads: Société Française d'Anesthésie et de Réanimation

This content was sourced from clinicaltrials.gov