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Restrictive Fluid Management In Liver Transplantation (REFIL)
Sponsor: Centre hospitalier de l'Université de Montréal (CHUM)
Summary
Hypothesis: A Canadian multicentre clinical trial is feasible. Study Design: Multicenter internal pilot parallel arm randomized controlled trial. Study population: Patients with end-stage liver disease (ESLD) undergoing a liver transplantation, not meeting any exclusion criteria. Primary feasibility endpoint: An overall recruitment rate ≥ 4 patients/month across all four participating sites. Secondary feasibility endpoints: A protocol adherence \> 90%, a 30-day (or hospital discharge) and 6-month outcome measurement \> 90%, and a mean difference in total intraoperative volume received (crystalloids and colloids combined) \> 1000 ml between groups. Study intervention: Low splanchnic blood volume restrictive fluid management strategy (intervention). A phlebotomy, performed prior to dissection and transfused back after graft reperfusion, combined with a hemodynamic goal-directed restrictive fluid management strategy. Optimized cardiac-output liberal fluid management strategy (control) A hemodynamic goal-directed liberal fluid management strategy that optimizes cardiac output throughout surgery.
Official title: Effects of an Intraoperative Low-splanchnic Blood Volume Restrictive Fluid Management Strategy Compared to a Cardiac Output Optimized Liberal Fluid Management Strategy on Postoperative Outcomes in Liver Transplantation
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
138
Start Date
2023-04-25
Completion Date
2026-03
Last Updated
2026-02-23
Healthy Volunteers
Yes
Conditions
Interventions
Low splanchnic blood volume restrictive fluid management strategy
Hemodynamic goal-directed restrictive fluid management strategy
Optimized cardiac output liberal fluid management strategy
Permissive hemodynamic goal-directed fluid management strategy that optimizes cardiac output throughout surgery
Phlebotomy
Retrieval of blood in a blood donation bag performed prior to dissection and transfused back after graft reperfusion
Locations (4)
Vancouver General Hospital
Vancouver, British Columbia, Canada
London Health Sciences Centre
London, Ontario, Canada
Centre Hospitalier de l'Université de Montréal (CHUM)
Montreal, Quebec, Canada
McGill University Health Centre
Montreal, Quebec, Canada