Parenteral ascorbinsyrerepletion ved transplantation (PARTI)
Parenteral ascorbinsyrerepletion ved transplantation (PARTI): Et randomiseret, dobbeltblindet, placebokontrolleret forsøg
A single-center, randomized, double-blinded placebo-controlled trial is proposed to investigate administration of supraphysiologic doses of ascorbic acid (vitamin C, AA) to patients undergoing liver transplantation. Participants randomized to the intervention group will receive intravenous (IV) AA 1500 mg every 6 hours for 48 hours. Participants randomized to the control group will receive a saline placebo. The primary study outcome will be a change in the Sequential Organ Failure Assessment (SOFA) score from baseline to three days after the first dose of drug (dSOFA3). Secondary outcomes will include total vasopressor dose in norepinephrine equivalents, 30-day and 1-year mortality, and serum AA levels.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
HYPOTHESIS: Administration of supraphysiologic doses of parenteral AA in the perioperative period for patients undergoing liver transplantation will improve Sequential Organ Failure Assessment (SOFA) scores, vasopressor usage and biochemical, cellular and clinical end-organ damage.
Specific Aim: Determine the clinical response to parenteral AA supplementation in patients undergoing liver transplantation by a randomized, double-blinded, placebo-controlled clinical trial.
Study Design: This study is a prospective, single-center, randomized trial in which 90 participants will be enrolled at the University of Wisconsin Hospitals and Clinics (UWHC). Participants must meet study eligibility criteria and be scheduled to undergo primary deceased donor solitary liver transplantation. Participants will be randomized to receive 8 doses of 1500 mg AA IV or volume-equivalent placebo every 6 hours for 48 hours, in addition to standard medical management.
Undersøgelsestype
Undersøgelsestype
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiesteder
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Wisconsin
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Madison, Wisconsin, Forenede Stater, 53792
- University of Wisconsin Hospital and Clinics
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- The subject is scheduled to undergo primary deceased donor solidary liver transplantation
Exclusion Criteria:
- Non-English speaking
- Known or believed to be pregnant
- Subject is a prisoner
- Impaired decision-making capacity (i.e., current encephalopathy)
- Known allergy to AA
- Concurrent organ transplantation (i.e., simultaneous liver-kidney transplantation)
- Planned veno-venous bypass use in the operating room
- Prior parenteral or oral AA repletion
- History of nephrolithiasis or oxaluria
- Vitamin C supplement use or administration (including HAT therapy) within the last month prior to transplantation
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- Sickle cell anemia
- Hereditary hemochromatosis
- Preoperative anuria or creatinine >2.5mg/dL in patient not on renal replacement therapy
- Current enrollment in another research study
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: Ascorbic Acid (AA)
The first intravenous dosage of 1500mg of AA in 100mL of normal saline (NS) will be administered after induction of general anesthesia and invasive line placement prior to surgical incision. An identical dosage will be delivered approximately every 6 hours for the first 48 hours, for a total of 8 doses |
Intravenous vitamin C
Andre navne:
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Placebo komparator: Placebo
The first intravenous dosage of placebo (100 mL of NS) will be administered after induction of general anesthesia and invasive line placement prior to surgical incision. An identical dosage will be delivered approximately every 6 hours for the first 48 hours, for a total of 8 doses |
Normal Saline |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Change in Sequential Organ Failure Assessment (SOFA) Score
Tidsramme: baseline to 3 days after first dose
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SOFA scores are a widely used composite measure of multiorgan dysfunction, validated as an accurate predictor of short- and long-term mortality in the general ICU and liver transplant populations. Change in SOFA from baseline (delta SOFA or dSOFA) has been shown to be more predictive of mortality than other derivatives such as absolute interval SOFA scores and has been recommended as the preferred endpoint in critical care settings The total possible range of scores is 0-24, higher scores are indicative of a higher degree of dysfunction. |
baseline to 3 days after first dose
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Serum AA niveauer
Tidsramme: Forbehandling (baseline) og efterbehandling (op til 1 uge)
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Forbehandling (baseline) og efterbehandling (op til 1 uge)
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Total vasopressordosis i noradrenalinækvivalenter pr. kilogram
Tidsramme: fra start af anæstesi (dag 1) til slutningen af ICU-ophold (op til 1 uge)
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fra start af anæstesi (dag 1) til slutningen af ICU-ophold (op til 1 uge)
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Dage på Ventilator
Tidsramme: postoperativt (op til ~ 7 dage)
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postoperativt (op til ~ 7 dage)
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Længde af intensivophold
Tidsramme: postoperativt (op til ~ 7 dage)
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postoperativt (op til ~ 7 dage)
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Længde af hospitalsophold
Tidsramme: postoperativt (op til ~ 30 dage)
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postoperativt (op til ~ 30 dage)
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30 dages dødelighed
Tidsramme: op til 30 dage efter operation
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op til 30 dage efter operation
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1-års dødelighed
Tidsramme: op til 1 år efter operation
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op til 1 år efter operation
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Incidence of Early Graft Dysfunction
Tidsramme: postoperative (up to 7 days or until discharge, whichever came first)
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As defined per Olthoff as: total bilirubin ≥10 or INR≥1.6 on day 7, or transaminase >2000 within first 7 days |
postoperative (up to 7 days or until discharge, whichever came first)
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Postoperative Day 7 SOFA Score
Tidsramme: postoperative (up to 3 days)
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Total range of scores 0-24 where higher scores indicate higher dysfunction. |
postoperative (up to 3 days)
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Incidence of Infection
Tidsramme: postoperative (up to ~ 7 days)
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Surgical site, bloodstream & intra-abdominal infection rates |
postoperative (up to ~ 7 days)
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Molly Groose, MD, MS, University of Wisconsin, Madison
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2020-1153
- A530900 (Anden identifikator: UW Madison)
- SMPH/ANESTHESIOLOGY (Anden identifikator: UW Madison)
- Protocol Version 12/5/2024 (Anden identifikator: UW Madison)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Data from this study may be requested from other researchers up to 7 years after the completion of the primary endpoint by contacting Dr. Molly Groose, the Principal Investigator of this study
IPD-delingstidsramme
up to 7 years after primary completion
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
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