Informations générales (source: ClinicalTrials.gov)
Perioperative Hemostasis Management in Liver Transplantation (HEMOTRANSPLANT)
Observational
Société Française d'Anesthésie et de Réanimation (Voir sur ClinicalTrials)
octobre 2024
mars 2026
05 novembre 2024
Liver transplantation (LT) is a surgery with risk of bleeding. Several risk factors have
been identified: complex dissection, portal hypertension, history of ascites fluid
infections, history of surgical procedures, pre-existing complex hemostatic disorders and
those acquired during the procedure. Diffuse bleeding can occur at any time during the 3
phases of surgery: dissection, anhepatic and neohepatic. However, intraoperative bleeding
and transfusion requirements remain difficult to predict. Current predictive models are
based in particular on preoperative characteristics and do not take into account the
course and different phases of the operation.
The need for transfusions has largely decreased over the last 20 years, and currently
around 20-25% of patients are transfused (transfusion of at least 1 blood product during
LT). However, massive transfusion is necessary in 10% of LT. The European Society of
Anaesthesiology (ESA) has issued recommendations on the management of severe bleeding
during surgery. However, these recommendations are not specific to LT. Moreover,
transfusion strategies vary widely from one center to another. The implementation of
protocols within teams dedicated to LT has led to a reduction in bleeding and
transfusion, with or without the use of viscoelastic testing.
Intraoperative bleeding and transfusion requirements, as well as postoperative
thromboembolic complications, remain difficult to predict. Predictive models of bleeding
risk have been developed, but they are based solely on preoperative characteristics and
do not take into account the course and various phases of the operation. In addition, new
methods such as Bayesian inference or machine learning have been developed, and seem
capable of providing different information from that obtained by conventional models.
The overall aim of this prospective multicenter observational study is to investigate the
risk factors for bleeding and thrombosis in per- and post-operative LT using different
predictive methods, and to describe the management of bleeding and post-operative
anticoagulation in metropolitan France.
Etablissements
| Les établissements d'Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| AP-HP - Hôpital Beaujon | Pauline DEVAUCHELLE, MD | Contact (sur clinicalTrials) | |||
| AP-HP - Hôpital Paul Brousse | Stephanie ROULLET, MD | Contact (sur clinicalTrials) | |||
| Les établissements sans correspondance certaine dans le répertoire FINESS dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
| Chru Minjoz - Besançon - France | Cyrielle DESPRES, MD | Contact (sur clinicalTrials) | |||
| CHU Claude Huriez - Lille - France | Anne BIGNON, MD | Contact (sur clinicalTrials) | |||
| CHU Estaing - Clermont - France | Renaud GUERIN, MD | Contact (sur clinicalTrials) | |||
| CHU Grenoble Alpes - Grenoble - France | Alexandre GODON, MD | Contact (sur clinicalTrials) | |||
| CHU Haut Levêque - Pessac - France | Elsa DELOGE, MD | Contact (sur clinicalTrials) | |||
| CHU Hautepierre - Strasbourg - France | Paul BRUNET, MD | Contact (sur clinicalTrials) | |||
| CHU La Timone - Marseille - France | Benedicte GRIGORESCO, MD | Contact (sur clinicalTrials) | |||
| CHU Pitié-Salpêtrière - Paris - France | Antoine MONSEL, MD | Contact (sur clinicalTrials) | |||
| CHU Pontchaillou - Rennes - France | Axelle MAURICE, MD | Contact (sur clinicalTrials) | |||
| CHU Toulouse Rangueil - Toulouse - France | Vincent ETIENNE, MD | Contact (sur clinicalTrials) | |||
| CHU Tours - Tours - France | Isaure BRETEAU, MD | Contact (sur clinicalTrials) | |||
| Hôpital de la Croix-Rousse - Lyon - France | Pierre JACQUENOD Pierre, MD | Contact (sur clinicalTrials) | |||
| Hôpital De L'Archet 2 - Nice - France | Romain ROZIER Romain, MD | Contact (sur clinicalTrials) | |||
| Hôpital St Eloi - Montpellier - France | Clément MONET, MD | Contact (sur clinicalTrials) | |||
Critères
Tous
Inclusion Criteria:
- Patients aged 18 or over
- Liver transplant patient
- Patients aged 18 or over
- Liver transplant patient
- Multi-organ transplantation
- Protected populations: under guardianship or curatorship
- Patients not affiliated to a social security scheme