Condition: Liver Cirrhosis · Clinically Significant Portal Hypertension · Sponsor: Medical University of Warsaw
Liver transplantation is a procedure associated with an exceptionally high risk of blood loss. Liver failure, which is the most common indication for transplantation, not only leads to coagulation disorders but also to the development of portal hypertension. As a result, collateral circulation forms within the abdominal venous system, significantly increasing the risk of massive intraoperative blood loss. The number of intraoperatively transfused units of red blood cell concentrate is one of the main predictors of serious complications and postoperative mortality. Patients with portal hypertension awaiting liver transplantation should be treated with non-selective β-blockers, which reduce pressure in the portal system. This is primarily justified by the need to prevent esophageal variceal bleeding, one of the most common causes of decompensation in chronic liver failure and a potential cause of death while awaiting liver transplantation. According to the Baveno VII guidelines, if bleeding recurs despite the use of non-selective β-blockers, a transjugular intrahepatic portosystemic shunt (TIPS) should be considered. Significant reduction of portal pressure is observed in up to 50% of patients treated with propranolol and up to 75% with carvedilol. TIPS effectively prevents bleeding caused by portal hypertension. However, recommendations for pre-transplant management of portal hypertension do not address the reduction of blood loss risk during liver transplantation. Previous…
This description comes directly from the study's public registry record.
Wacław Hołówko, dr hab. n. med. · +48 667 667 044 · waclaw.holowko@wum.edu.pl
Zuzanna Łuczak · luczakpresite@gmail.com
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| University Clinical Centre of the Medical University of Warsaw | Warsaw, Poland | Recruiting |
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Source record: clinicaltrials.gov/study/NCT07111221