Effect of Preoperative CIMT on Hemodynamics During Liver Transplantation

Condition(s) studied

Study summary

Candidates for liver transplantation (CT) carry an increased risk of cardiovascular disease (CVD) due to underlying end-stage liver disease (ESHD) and immunosuppressive drugs used post-transplantation. CVD is a significant cause of long-term mortality after CT \[1\] \[2\]. Carotid Intima-Media Thickness (CIMT), a subclinical marker of atherosclerosis in the preoperative period, is a non-invasive method used to predict future CVD risk \[3\]. High CIMT indicates atherosclerosis and decreased arterial compliance. This can compromise organ perfusion and increase the risk of postoperative complications by increasing intraoperative blood pressure variability (BPV) during anesthesia induction and surgical stress in major surgeries such as CT. Studies investigating whether CIMT is an independent risk factor for perioperative hemodynamic instability in CT patients are limited. The aim of our study is to investigate the effect of CIMT values on intraoperative hemodynamic parameters. Secondary objectives are to determine the association of CIMT with the incidence of hypotension, vasopressor requirement, postoperative acute renal injury (ARI), and major cardiac adverse events (MCAE) after anesthesia induction.

Theoretical Benefit: To make a significant contribution to the literature on the relationship between atherosclerosis and anesthesia management by determining whether CIMT is an independent predictor of perioperative hemodynamic instability in chemotherapy patients.

Practical Benefit: To ensure the inclusion of CIMT measurement in the anesthesia risk assessment of chemotherapy candidates. Identifying patients with high CIMT will guide the implementation of more aggressive and targeted hemodynamic management strategies (e.g., more frequent invasive monitoring, proactive vasopressor use) during anesthesia induction and maintenance.

Eligibility

Primary outcome measure(s)

• The Effect of Preoperative Carotid Intima-Media Thickness on Intraoperative Hemodynamic Profile in Liver Transplant Patients — from january 2023 to july 2026
  Correlation Between Preoperative Carotid Intima-Media Thickness and Intraoperative Mean Arterial Pressure
• Correlation Between Preoperative Carotid Intima-Media Thickness and Intraoperative Vasopressor Consumption — from jan 2023 to july 2026
  The correlation coefficient (r value) will be calculated to assess the linear relationship between preoperative carotid intima-media thickness (measured in millimeters via ultrasonography) and the total dose or duration of intraoperative vasopressor support (e.g., noradrenaline, ephedrine, or dopamine) required to maintain hemodynamic stability.

Trial sites (1)

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