Continuous Renal Replacement Therapy in the Setting of Orthotopic Liver Transplant

Study Overview
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Brief Summary
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To evaluate the efficacy of continuous renal replacement therapy (CRRT) during orthotopic liver transplantation (OLT) in clearing excess solutes and improving acid-base parameters. The investigators hypothesize that the use of intra-operative CRRT in OLT recipients is associated with increased solute removal and improved acid-base statues when compared to controls who do not receive CRRT

Detailed Description
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as above

Official Title
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Continuous Renal Replacement Therapy in the Setting of Orthotopic Liver Transplant: A Randomized Trial

Conditions
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Acute Kidney Injury, Liver Disease, Chronic Kidney Disease, End Stage Kidney Disease

Intervention / Treatment
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* Procedure: Renal replacement therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 or older and able to sign consent (or surrogate) Receiving liver or combined liver-kidney transplant eGFR < or equal to 40 ml/min immediately prior to transplant or currently on any form of renal replacement therapy for acute kidney injury or end-stage renal disease Pre-operative potassium of < or equal to 5.5 mEq/L Exclusion Criteria: Pre-operative hemoglobin < or equal to 7 g/dL Pre-operative weight > or equal to 125 kig

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Renal replacement therapy<br>Liver transplant recipients who receive continuous renal replacement therapy intra-operatively. | Procedure: Renal replacement therapy<br>* Liver transplant recipients receiving continuous renal replacement therapy for duration of liver transplant surgery.<br>|
| Active Comparator: No CRRT<br>This arm consists of standard of care without CRRT in the OR for OLT | Procedure: Renal replacement therapy<br>* Liver transplant recipients receiving continuous renal replacement therapy for duration of liver transplant surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Solute Clearance | To compare the clearance of solutes (ie. potassium, lactate, creatinine and blood urea nitrogen) by CRRT in renally impaired OLT recipients to OLT recipients who do not receive CRRT | Intra-operative time | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Renal function and patient outcomes | To compare long-term maintenance of renal function (12 months) and other health outcomes in OLT recipients who received CRRT versus OLT recipients who did not receive OLT | 1 year post-operatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute Kidney Injury, Continuous Renal Replacement Therapy, Liver Transplant