Phase I clinical trial of the feasibility and safety of direct peritoneal resuscitation in liver transplantation.

Rodriguez, Ivan E; Asher, Zachary P; Klingenberg, Katherine; Wright, Franklin L; Nydam, Trevor L; Adams, Megan A; Bababekov, Yanik J; Peltz, Eric; Smith, Jason W; Saben, Jessica L; Kennealey, Peter; Pomposelli, James J; Pomfret, Elizabeth A; Moore, Hunter B

Rodriguez, Ivan E; Asher, Zachary P; Klingenberg, Katherine; Wright, Franklin L; Nydam, Trevor L; Adams, Megan A; Bababekov, Yanik J; Peltz, Eric; Smith, Jason W; Saben, Jessica L; Kennealey, Peter; Pomposelli, James J; Pomfret, Elizabeth A; Moore, Hunter B.

Afiliação

Rodriguez IE; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Asher ZP; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Klingenberg K; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Wright FL; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Nydam TL; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Adams MA; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Division of Transplant Surgery, Department of Surgery, Children's Hospital Colorado, Aurora, CO, USA.
Bababekov YJ; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Peltz E; Department of Surgery, Logan Health Medical Center, Kalispell, MT, USA.
Smith JW; Department of Surgery, University of Louisville Health, Louisville, KY, USA.
Saben JL; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Kennealey P; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Pomposelli JJ; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Pomfret EA; Colorado Center for Transplantation Care, Research, and Education (CCTCARE), Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Moore HB; AdventHealth Transplant Institute at Porter, Denver, CO, USA. Electronic address: Hunter.Moore@adventhealth.com.

Am J Surg ; : 115815, 2024 Jul 02.

Article em En | MEDLINE | ID: mdl-39003094

ABSTRACT

ABSTRACT

BACKGROUND:

Direct peritoneal resuscitation (DPR) is associated with improved outcomes in trauma. Animal models suggest DPR has favorable effects on the liver. We sought to evaluate its safety and assess for improved outcomes in liver transplantation (LT).

METHODS:

LT patients with renal dysfunction and/or obesity were enrolled in a phase-I clinical trial. DPR lasted 8-24 âh depending on postoperative disposition. Primary outcome was percent of patients completing DPR. Secondary outcomes evaluated complications. Controls with either obesity (control-1) or both risk factors (obesity â+ ârenal dysfunction, control-2) were analyzed.

RESULTS:

Fifteen patients were enrolled (seven with both criteria and eight with obesity alone). DPR was completed in 87 â% of patients, with one meeting stopping criteria. Controls included 45 (control-1) and 24 (control-2) patients. Return to operating room, graft loss, and late infections were lower with DPR.