Organ Dysfunction Associated With Intra Abdominal Pressures in Liver Transplantation

Study Overview
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Brief Summary
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Patients with end stage liver disease have varying degrees of intra-abdominal hypertension (IAH) due to the presence of ascites. The perioperative events may either relieve or aggravate the intra-abdominal pressures. Intra-abdominal hypertension has damaging effect on various organ systems. There is an increase in intracranial pressures and a decrease in cerebral perfusion pressures associated with IAH . In the heart, there is an increase of right atrial pressures, increase in systemic vascular resistance and decrease in cardiac output . Pulmonary complications include increase in the peak, mean and plateau airway pressures, with decreased compliance . Renal dysfunction is an early effect of raised intra-abdominal pressure, resulting from decreased renal blood flow, shunting of blood to the medulla, mechanical compression of the kidneys and increased pressures in the renal veins . We would study the intra-abdominal pressures in liver transplant recipients and record hemodynamic, respiratory, cardiac and renal function prospectively. Follow up data for 6 days for neurological, respiratory, cardiac and renal complications will be collected, along with hospital stay, ICU stay and mortality. The association between intra-abdominal pressures and these outcomes will be analysed.

Official Title
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Organ Dysfunction Associated With Intraabdominal Pressures in Liver Transplantation

Conditions
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Liver Diseases, Intra-Abdominal Hypertension, Cirrhosis, Liver, Organ Dysfunction Syndrome

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing liver transplantation 18 to 65 years Exclusion Criteria: pregnant patients primary diagnosis of Acute liver failure and acute on chronic liver failure

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Liver Transplant Recipients<br>adult patients undergoing liver transplantation | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 28 day mortality | mortality of any cause in the fist 28 days after transplantation | 28 days | 
| duration of icu stay | time period spent in the intensive care unit | 28 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acute kidney injury in 1st week | incidence of acute kidney injury in 1 week of transplantation | 7 days | 
| Respiratory complications | includes duration of ventilation, incidence of vap | 7 days | 
| major neurological complications | any major neurological event | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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organ dysfunction, intra-abdominal pressure, liver transplantation, liver cirrhosis