EBD RCT Trial in Living Donor Liver Transplantation
Study Details
Study Description
Brief Summary
This study was designed to demonstrate incidence of biliary complication rates after living donor liver transplantation according to the implantation of external biliary drainage throug duct-to-duct anastomosis site.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Biliary complication is the most common complications after liver transplantation, and it happens more often after living donor liver transplantation (LDLT) than deceased donor liver transplantation.
Many transplant centers adopted their own methods to improve biliary complications after LDLT. One suggested method is the application of external biliary drainage (EBD).
A prospective study was planned to demonstrate effect of EBD on biliary complication after LDLT. Patients who underwent LDLT with duct-to-duct anastomosis will be randomly assinged to application of EBD or conventional duct-to-duct anastomosis without EBD according to a computer generated randomization sequence and allocated in a 1:1 ratio to one of two groups.
Primary outcome is biliary complication incidence 1 year after LDLT.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Experimental group Application of external biliary drainage |
Procedure: External biliary drainage
Application of external biliary drainage through duct-to-duct anastomosis
|
| No Intervention: Control group Conventional duct-to-duct anastomosis (with or without internal stent) |
Outcome Measures
Primary Outcome Measures
- Incidence of biliary complication within 1 year after LDLT [1 year]
Biliary stricture/leakage
Secondary Outcome Measures
- Incidence of biliary complication within 3 year after LDLT [3 year]
Biliary stricture/leakage
- Complication associated with external biliary drainage [3 year]
Dislocation, retraction, reposition, leakage through tube site, hemorrhage
- Graft survival [3 year]
Survival of liver graft
- Patient survival [3 year]
Patient survival after LDLT
- Patient-reported outcome [3 year]
Questionnaire survey
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Living donor liver transplantation
-
Adult patient (>=18 years old)
-
Patients who are available for at least 3 year follow-up after LDLT
Exclusion Criteria:
-
Patients requring hepaticojejunostomy due to anatomical factor or underlying disease
-
Re-transplantation
-
Multiorgan transplantation
-
Emergency transplantation
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Seoul National University Hospital | Seoul | Korea, Republic of |
Sponsors and Collaborators
- Seoul National University Hospital
Investigators
- Study Chair: Suk Kyun Hong, MD, Seoul National University Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Akamatsu N, Sugawara Y, Hashimoto D. Biliary reconstruction, its complications and management of biliary complications after adult liver transplantation: a systematic review of the incidence, risk factors and outcome. Transpl Int. 2011 Apr;24(4):379-92. doi: 10.1111/j.1432-2277.2010.01202.x. Epub 2010 Dec 10. Review.
- Freise CE, Gillespie BW, Koffron AJ, Lok AS, Pruett TL, Emond JC, Fair JH, Fisher RA, Olthoff KM, Trotter JF, Ghobrial RM, Everhart JE; A2ALL Study Group. Recipient morbidity after living and deceased donor liver transplantation: findings from the A2ALL Retrospective Cohort Study. Am J Transplant. 2008 Dec;8(12):2569-79. doi: 10.1111/j.1600-6143.2008.02440.x. Epub 2008 Oct 24.
- Hwang S, Lee SG, Sung KB, Park KM, Kim KH, Ahn CS, Lee YJ, Lee SK, Hwang GS, Moon DB, Ha TY, Kim DS, Jung JP, Song GW. Long-term incidence, risk factors, and management of biliary complications after adult living donor liver transplantation. Liver Transpl. 2006 May;12(5):831-8.
- Jung DH, Ikegami T, Balci D, Bhangui P. Biliary reconstruction and complications in living donor liver transplantation. Int J Surg. 2020 Oct;82S:138-144. doi: 10.1016/j.ijsu.2020.04.069. Epub 2020 May 5. Review.
- Lee SG. A complete treatment of adult living donor liver transplantation: a review of surgical technique and current challenges to expand indication of patients. Am J Transplant. 2015 Jan;15(1):17-38. doi: 10.1111/ajt.12907. Epub 2014 Oct 30. Review.
- Park CS, Jung BH, Hwang S, Park YH, Kang SH, Park GC, Song GW, Jung DH, Ahn CS, Kim KH, Moon DB, Ha TY, Lee SG. External biliary drainage in living donor liver transplantation using duct-to-duct anastomosis. Transplant Proc. 2014 Apr;46(3):678-81. doi: 10.1016/j.transproceed.2013.11.150.
- SNUHLT_EBD