- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03369210
Liberal Transfusion Strategy in Elderly Patients (LIBERAL)
Liberal Transfusion Strategy to Prevent Mortality and Anaemia-associated, Ischaemic Events in Elderly Non-cardiac Surgical Patients
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Patrick Meybohm, MD
- Phone Number: 004993120130001
- Email: meybohm_p@ukw.de
Study Locations
-
-
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Augsburg, Germany
- Recruiting
- University Hospital Augsburg
-
Contact:
- Ulrich Jaschinski
-
Sub-Investigator:
- Maria Zanquilla
-
Berlin, Germany
- Recruiting
- Berlin Charite CCM
-
Contact:
- Stefan Schaller
-
Sub-Investigator:
- Sascha Tafelski
-
Berlin, Germany
- Recruiting
- Charite Berlin CBF
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Contact:
- Sascha Treskatsch
-
Sub-Investigator:
- Christian Berger
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Bonn, Germany
- Recruiting
- University Hospital Bonn
-
Contact:
- Markus Velten
-
Sub-Investigator:
- Maria Wittmann
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Dortmund, Germany
- Not yet recruiting
- Klinikum Dortmund
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Contact:
- Richard Ellerkmann
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Sub-Investigator:
- Holger Pohl
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Frankfurt, Germany
- Recruiting
- University Hospital Frankfurt
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Contact:
- Kai Zacharowski
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Sub-Investigator:
- Simone Lindau
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Hamburg, Germany
- Recruiting
- University Hospital Hamburg
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Contact:
- Lars Eichler
-
Sub-Investigator:
- Mark Punke
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Jena, Germany
- Recruiting
- University Hospital Jena
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Contact:
- Michael Bauer
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Sub-Investigator:
- Frank Bloos
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Kiel, Germany
- Recruiting
- University Hospital Schleswig-Holstein
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Contact:
- Gunnar Elke
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Sub-Investigator:
- Dirk Schädler
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Mainz, Germany
- Recruiting
- University Hospital Mainz
-
Contact:
- Eva Wittenmeier
-
Sub-Investigator:
- Michael Schuster
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Münster, Germany
- Recruiting
- University Hospital Munster
-
Contact:
- Alexander Zarbock
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Sub-Investigator:
- Melanie Meersch
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Münster, Germany
- Recruiting
- St. Franziskus Hospital Munster
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Contact:
- Ullrich Göbel
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Sub-Investigator:
- Andre Hemping-Bovenkerk
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Regensburg, Germany
- Recruiting
- University Hospital Regensburg
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Contact:
- Diane Bitzinger
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Sub-Investigator:
- Karin Pfister
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Würzburg, Germany, 97080
- Recruiting
- University Hospital Würzburg
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Contact:
- Patrick Meybohm, MD
- Phone Number: 004093120130001
- Email: meybohm_p@ukw.de
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Principal Investigator:
- Peter Kranke, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients ≥ 70 years of age scheduled for intermediate- or high-risk non-cardiac surgery will be registered
- Registered patients will be randomised only if they indeed develop severe anaemia (if Hb level falls ≤ 9 g/dl) during surgery (=day 0) or day 1, 2, or 3 after surgery
Exclusion Criteria:
- preoperative Hb level ≤ 9 g/dl
- chronic kidney disease requiring dialysis
- suspected lack of compliance with follow-up procedures
- participation in other interventional trials
- expected death within 3 months
- inability to provide informed consent with absence of a legally authorised representative/ legal guardian
- temporary inability to provide informed consent
- previous participation in our trial
- patients who are prevented from having blood and blood products according to a system of beliefs (e.g. Jehovah's Witnesses)
- preoperative autologous blood donation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Liberal
Liberal group (patients receive a RBC unit each time Hb falls ≤ 9 g/dl (≤ 5.6mmol/l) with a target range for the post-transfusion Hb level of 9-10.5 g/dl (5.6-6.5 mmol/l)).
|
patients receive a RBC unit with different target ranges for the post-transfusion Hb levels
|
Active Comparator: Restrictive
Restrictive group (patients receive a single RBC unit each time Hb falls ≤ 7.5 g/dl (≤ 4.7 mmol/l) with a target range for the post-transfusion Hb level of 7.5-9 g/dl (4.7-5.6 mmol/l).
|
patients receive a RBC unit with different target ranges for the post-transfusion Hb levels
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Occurrence of a composite endpoint
Time Frame: 90 days
|
Composite of death and anaemia-associated events I. All-cause mortality defined as death from any cause. II. Acute myocardial infarction confirmed by a cardiologist III. Acute ischaemic stroke confirmed by a neurologist IV. Acute kidney injury (stage III) defined according to the Kidney Disease Improving Global Outcomes criteria: Increase of plasma creatinine level ≥ 3 times within a time window of 7 days or initiation of renal replacement therapy. V. Acute mesenteric ischaemia defined as ischaemia confirmed by intervention (abdominal surgery or mesenteric angiography). VI. Acute peripheral vascular ischaemia defined as a new non-thrombotic compromised circulation in a limb confirmed by angiography and/or leading to surgery. |
90 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of patients receiving red blood cell transfusion
Time Frame: hospital discharge (an anticipated average of 10 days)
|
hospital discharge (an anticipated average of 10 days)
|
|
Number of red blood cell units transfused
Time Frame: hospital discharge (an anticipated average of 10 days)
|
hospital discharge (an anticipated average of 10 days)
|
|
Total length of stay in the intensive care unit
Time Frame: hospital discharge (an anticipated average of 10 days)
|
hospital discharge (an anticipated average of 10 days)
|
|
Total length of stay in hospital
Time Frame: hospital discharge (an anticipated average of 10 days)
|
hospital discharge (an anticipated average of 10 days)
|
|
Number of participants with acute kidney injury stage I-II
Time Frame: hospital discharge (an anticipated average of 10 days)
|
The occurrence of acute kidney injury (stage I or II) defined according to the Kidney Disease Improving Global Outcomes criteria (stage I: increase of plasma creatinine level ≥ 1.5-1.9
times baseline or ≥ 0.3mg/dl within 48 hours; stage II: increase of plasma creatinine level ≥ 2-2.9 times baseline within a time window of 7 days) during the initial hospital stay
|
hospital discharge (an anticipated average of 10 days)
|
Time to infection
Time Frame: 90 days
|
Time to (first) infection (infection requiring therapeutic intravenous antibiotic treatment (pneumonia, wound infection, sepsis, central line associated blood stream infection)) during the initial hospital stay or leading to hospital re-admission
|
90 days
|
Time to re-hospitalisation
Time Frame: 90 days
|
Time to (first) re-hospitalisation
|
90 days
|
functional status (Barthel index)
Time Frame: 90 days
|
Functional status (assessed by Barthel Index)
|
90 days
|
Health-related quality of life
Time Frame: 90 days
|
Health-related quality of life (assessed by EuroQoL EQ-5D and 12-item World Health Organisation Disability Assessment Schedule WHODAS 2.043) by telephone questionnaire)
|
90 days
|
Occurrence of any individual component of the composite
Time Frame: 1 year
|
composite components (all-cause mortality, acute myocardial infarction, acute stroke, acute kidney injury stage III, acute mesenteric ischaemia, and/or acute peripheral vascular ischaemia)
|
1 year
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Patrick Meybohm, MD, Wuerzburg University Hospital
Publications and helpful links
General Publications
- Carson JL, Stanworth SJ, Dennis JA, Trivella M, Roubinian N, Fergusson DA, Triulzi D, Doree C, Hebert PC. Transfusion thresholds for guiding red blood cell transfusion. Cochrane Database Syst Rev. 2021 Dec 21;12(12):CD002042. doi: 10.1002/14651858.CD002042.pub5.
- Meybohm P, Lindau S, Treskatsch S, Francis R, Spies C, Velten M, Wittmann M, Gueresir E, Stoppe C, Kowark A, Coburn M, Selleng S, Baschin M, Jenichen G, Meersch M, Ermert T, Zarbock A, Kranke P, Kredel M, Helf A, Laufenberg-Feldmann R, Ferner M, Wittenmeier E, Gurtler KH, Kienbaum P, de Abreu MG, Sander M, Bauer M, Seyfried T, Gruenewald M, Choorapoikayil S, Mueller MM, Seifried E, Brosteanu O, Bogatsch H, Hasenclever D, Zacharowski K; LIBERAL Collaboration Group. Liberal transfusion strategy to prevent mortality and anaemia-associated, ischaemic events in elderly non-cardiac surgical patients - the study design of the LIBERAL-Trial. Trials. 2019 Feb 4;20(1):101. doi: 10.1186/s13063-019-3200-3.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 139/17F
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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