Interest of an Early Rehabilitation Program in Liver Transplant Surgery

Study Overview
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Brief Summary
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Monocentric, prospective study to evaluate 10 liver transplanted patients

Detailed Description
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The improvement of perioperative technics and the prevention of complications with immunosuppression allowed for the development with success of liver transplant. 1322 liver transplants occurred in 2016 in France to 806 in 2000. Centre Hospitalier Universitaire (CHU) of Rennes became a reference with 122 liver transplants in 2016 being the second liver transplant center in France. Early rehabilitation concept is a multidisciplinary approach (surgical, anesthetic…) that aims to reduce the length of hospital stay and peri operative morbidity/mortality. These programs have first been developed in colorectal surgery before extending to complicated surgery like cephalic duodeno-pancreatectomy or hepatectomy. There are poor data in the literature on early rehabilitation program in liver transplant.

Official Title
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Early Rehabilitation Program in Liver Transplant Surgery: Hospital Discharge at Day 7 in a Targeted Population

Conditions
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Liver Transplantation

Intervention / Treatment
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* Other: Rehabilitation program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient older than 18 years old First liver transplant Liver transplant alone MELD (Model for End stage Liver Disease) score ≤ 15 CHILD-PUGH score ≤ 8 if cirrhosis Body Mass Index < 30 kg/m2 No history of transplant nor immunosuppression Absence of ascites nor hydrothorax drain Absence of treatment for diabetes Absence of renal insufficiency (glomerular filtration flow > 60 mL/min) Family help at home Exclusion Criteria: Cold ischemia time > 8 hours Grafts from type III Maastricht Super urgent liver transplantation Perioperative blood transfusion > 4 packed red blood cells and/or 3 fresh frozen plasma Arterial anastomosis in splenic artery, in aorta or in coeliac artery Bilio-digestive anastomosis Persons deprived of liberty Pregnant or breastfeeding women

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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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Hospital discharge at day 7<br> | Other: Rehabilitation program<br>* The patients follow different rehabilitation programs (surgery, anesthetic, post-operative). Hospital discharge is authorized only after validation of objective, clinical and para clinic criteria<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with an hospital discharge at day 7 |  | Day 7 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients readmission in the first month |  | Month 1 | 
| Number of days of hospitalization during the first month (post-surgery and prehospitalization) |  | Month 1 | 
| Number of death in the first month |  | Month 1 | 
| Satisfaction of the patient in the first month |  | Month 1 | 
| Number of surgery complications according to Dindo and Clavien classification during the first month |  | Month 1 |