Intraoperative Phlebotomy in Living Donor Liver Transplant- Means to Minimize Blood Transfusion: A Randomised Controlled Trial
Ethical Clearance
Approved
Investigating Team
Dr. Prachi Gokula, Dr. Vijay Vohra, Dr. Prashant Bhangui, Dr. A. S Soin, Dr. Disha Rajput, Dr. Pooja Bhangui, Dr. Annu Sarin Jolly, Dr. Nishant Sharma, Dr. Akansha Sangwan, Dr. Ninad Chodankar, Dr. Anu; Medanta, The Medicity, Gurugram
Study Design
Study Design- Prospective Randomized Controlled Trial
• Patients will be randomised into either of the two groups-
• Phlebotomy Group: Patients who will undergo controlled intraoperative hypovolemic phlebotomy (7-10ml/kg)
• Control Group: Patients who will not undergo intra-operative phlebotomy.
Inclusion criteria:
•Adult patients aged between 18-65years planned to undergo living donor liver transplant.
Exclusion criteria:
•Patients who refuse to consent to participate in the study.
•Patients aged less than 18years of age.
•Patients of acute liver failure
•Patients planned for re-transplantation.
•Patients planned for combined procedure (SLKT; LT+CABG)
•Patients with preoperative hemoglobin <7.0 gm/dl
•Patients with EF<50%
•Patients with chronic kidney disease, eGFR <30ml/min/1.73m2 MDRD, H/O renal replacement therapy within last two weeks
Primary Outcome
To compare intraoperative red cell transfusion requirements (units) between the groups.
Secondary Outcome
• Intraoperative fluid requirement [Crystalloids (ml); Colloids (ml) and 25% Albumin(ml)]
• Vasopressor requirement (Noradrenaline- mcg/kg/min and Vasopressin- total units)
• Incidence of postoperative renal dysfunction (KDIGO criteria- on POD1, POD3 and POD7)
• Evaluate pulmonary outcomes.