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Advanced Chronic Liver DiseaseNCT04615091

Non-invasive Methods and Surgical Risk Stratification in Cirrhotics Undergoing Elective Extrahepatic Surgery

An observational study of Advanced Chronic Liver Disease and Surgery--Complications, run by Azienda Ospedaliera Universitaria Integrata Verona at 37 sites in 12 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The ELASTO-SURGERY study aims to evaluate the prognostic role of portal hypertension evaluated by non-invasive methods in predicting post-operative morbidity (at 90 days) and mortality (at 365 days) in patients with advanced chronic liver disease undergoing elective extrahepatic surgery. Read more about this study

Who is it for?
Ages 18 years and older
How many people
250 participants
Where
37 sitesin 12 countries
Study dates
30 Aug 2020to Aug 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Advanced chronic liver disease patients who are planned an elective extrahepatic surgery (abdominal, orthopaedics and thoracic-cardiovascular surgeries)

Who may be able to join

  • Age > 18 yrs;
  • Advanced chronic liver disease (LSM>10 kPa)
  • Any etiology (viral, metabolic, alcoholic, cholestatic and autoimmune);
  • Elective extrahepatic surgery planned within three months and requiring regional or general anaesthesia;
  • Patients are willing and able to give informed consent

Who cannot join

  • Presence of hepatic decompensation at the time of informed consent or previous events of hepatic decompensation during the last three months before enrollment.
  • Presence of portal vein thrombosis
  • Previous placement of TIPS,
  • Prior liver transplantation,
  • Surgical resection or shunt.
  • Presence of active HCC that needed treatment at the time of informed consent

Trial locations and contacts

37 sites in 12 countries.

FEDERICO RAVAIOLI, MD; PhD contact

+393333176759

f.ravaioli@unibo.it

ELTON DAJTI, MD contact

elton.dajti2@unibo.it

37 sites in 12 countries

Italy11 sites, 11 recruiting
  • Clinica di Gastroenterologia ed Epatologia Ancona

    Ancona

    Luca Maroni, l.maroni@staff.univpm.it

    Not yet recruiting
  • Gastroenterology Unit - Azienda Ospedaliera Universitaria Sant'Orsola - Malpighi

    Bologna, 40138

    Amanda Vestito, MD, amanda.vestito@aosp.bo.it

    Elton Dajti, MD, elton.dajti@studio.unibo.it

    Not yet recruiting
  • Ospedale di Bolzano

    Bolzano

    Andrea Mega, andreamega@hotmail.com

    Not yet recruiting
  • Azienda ospedaliero-universitaria Careggi

    Florence

    Fabio Marra, fabio.marra@unifi.it

    Not yet recruiting
  • Policlinico di Milano

    Milan

    Mirella Fraquelli, mfraquelli@yahoo.it

    Not yet recruiting
  • Policlinico di Modena

    Modena

    Filippo Schepis, fschepis@unimore.it

    Not yet recruiting
  • Gastroenterology Unit, University of Palermo

    Palermo

    Vincenza Calvaruso, vincenza.calvaruso@unipa.it

    Not yet recruiting
  • Università Sapienza

    Roma

    Domenico Alvaro, domenico.alvaro@uniroma1.it

    Not yet recruiting
  • A.O.U. Città della Salute e della Scienza di Torino

    Torino

    Giorgio Maria Saracco, giorgiomaria.saracco@unito.it

    Not yet recruiting
  • ASUGI Clinica Patologie del Fegato, Clinica Chirurgica

    Trieste

    Saveria Lory Crocè, lcroce@units.it

    Not yet recruiting
  • Aoui Borgo Trento

    Verona, VR, 37126

    ANTONIO COLECCHIA, MD, 0458122310, antonio.colecchia@aovr.veneto.it

    CATERINA CUSUMANO, MD, 0458122310, caterina.cusumano@aovr.veneto.it

    Recruiting

Other trials in Italy

France10 sites, 10 recruiting
  • University hospital of Angers

    Angers

    Paul Calès, paul.cales@univ-angers.fr

    Not yet recruiting
  • Hopital Jean Verdier

    Bondy

    Pierre Nahon, pierre.nahon@jvr.aphp.fr

    Not yet recruiting
  • Hôpital Jean Verdier

    Bondy

    Nathalie Ganne-Carriè, nathalie.ganne@jvr.aphp.fr

    Not yet recruiting
  • Bordeaux University Hospital

    Bordeau

    Victor De Ledinghen, victor.deledinghen@chu-bordeaux.fr

    Not yet recruiting
  • Hôpital Beaujon

    Clichy

    Pierre Emmanuel Rautou, pierre-emmanuel.rautou@inserm.fr

    Not yet recruiting
  • Hospices Civils de Lyon Hopital Hotel Dieu

    Lyon

    Francois Bailly, francois.bailly@chu-lyon.fr

    Not yet recruiting
  • Centre Hospitalier de Montpellier

    Montpellier

    Christophe Cassinotto, christophe.cassinotto@chu-bordeaux.fr

    Not yet recruiting
  • hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris

    Paris

    Gabriel Perlemuter, gabriel.perlemuter@aphp.fr

    Not yet recruiting
  • Hôpital de la Pitié-Salpêtrière

    Paris

    Dominique Thabut, dominique.thabut@aphp.fr

    Not yet recruiting
  • Purpan Hospital Toulouse

    Toulouse

    Christophe Bureau, bureau.c@chu-toulouse.fr

    Not yet recruiting

Other trials in France

South Korea3 sites, 3 recruiting
  • Hanyang University Guri Hospital

    Hanyang

    Yongsoo Kim

    Not yet recruiting
  • Boramae Internal Medicine

    Seoul

    Won Kim, kimwon@snuh.org

    Not yet recruiting
  • Yonsei University College of Medicine

    Seoul

    Seung Up Kim, ksukorea@yuhs.ac

    Not yet recruiting

Other trials in South Korea

Canada2 sites, 2 recruiting
  • University of Alberta Hospital

    Edmonton

    Juan Abraldes, juan.g.abraldes@ualberta.ca

    Not yet recruiting
  • McGill University Health Centre

    Montreal

    Giada Sebastiani, giada.sebastiani@mcgill.ca

    Not yet recruiting

Other trials in Canada

Spain2 sites, 2 recruiting
  • Barcelona Hepatic Hemodynamic Lab. Liver Unit. Hospital Clinic. Barcelona

    Barcelona

    Juan Carlos Garcia-Pagan, jcgarcia@clinic.cat

    Not yet recruiting
  • Hospital Universitario Puerta de Hierro Majadahonda

    Madrid

    José Luís Calleja Panero, joseluis.calleja@uam.es

    Not yet recruiting

Other trials in Spain

Switzerland2 sites, 2 recruiting
  • Inselspital

    Bern

    Annalisa Berzigotti, annalisa.berzigotti@insel.ch

    Not yet recruiting
  • Ente Ospedaliero Cantonale

    Lugano

    Andrea De Gottardi, andrea.degottardi@eoc.ch

    Not yet recruiting

Other trials in Switzerland

United Kingdom2 sites, 2 recruiting
  • UCL Sheila Sherlock

    London

    Massimo Pinzani, m.pinzani@ucl.ac.uk

    Not yet recruiting
  • Room Nottingham Digestive Diseases Centre BRU

    Nottingham

    Neil Guha, neil.guha@nottingham.ac.uk

    Not yet recruiting

Other trials in United Kingdom

United States1 site, 1 recruiting
  • Yale New Haven Hospital

    New Haven, Connecticut, 06510

    Guadalupe Garcia-Tsao, guadalupe.garcia-tsao@yale.edu

    Not yet recruiting

Other trials in United States

Austria1 site, 1 recruiting
  • Medical University of Vienna

    Vienna

    Thomas Reiberger, thomas.reiberger@meduniwien.ac.at

    Not yet recruiting

Other trials in Austria

Denmark1 site, 1 recruiting
  • Odense University Hospital

    Odense

    Maja Thiele, maja.thiele@rsyd.dk

    Not yet recruiting

Other trials in Denmark

Germany1 site, 1 recruiting
  • University Hospital Leipzig

    Leipzig

    Thomas Karlas, thomas.karlas@medizin.uni-leipzig.de

    Not yet recruiting

Other trials in Germany

Hong Kong1 site, 1 recruiting
  • The Chinese University of Hong Kong

    Hong Kong

    Grace Wong, wonglaihung@cuhk.edu.hk

    Not yet recruiting

Other trials in Hong Kong

About this study

Official title: "Prognostic Role of Portal Hypertension Assessed by Non-invasive Methods to Stratify Surgical Risk in Compensated Advanced Chronic Liver Disease Patients Undergoing Elective Extrahepatic Surgery: ELASTOSURGERY STUDY."

The ELASTO-SURGERY study aims to evaluate the prognostic role of portal hypertension evaluated by non-invasive methods in predicting post-operative morbidity (at 90 days) and mortality (at 365 days) in patients with advanced chronic liver disease undergoing elective extrahepatic surgery.

Read the detailed description

In the last years, the life expectancy of ACLD patients has increased due to the improvement of the therapeutic strategies of the complications of cirrhosis. .Although surgical procedures have become less invasive the mortality rate in ACLD patients undergoing extrahepatic surgery remains high. For these reasons, an accurate prediction of operative risk for patient-tailored surgical planning becomes crucial.

Purpose of the study: To evaluate the prognostic role of portal hypertension by non- invasive methods in predicting post-operative complications in ACLD patients undergoing elective extrahepatic surgery.

Study type: An international multicenter, prospective, uncontrolled observational study

Study design: In cirrhotic patients undergoing extrahepatic surgery, within one month, a complete baseline evaluation is provided. Baseline evaluation (T0) includes: signature of informed consent, clinical history of liver disease, comorbidities and risk factors for hepato-biliary complications; complete laboratory tests; liver and spleen elastography (with Transient Elastography, ARFI or 2D-SWE).

After surgery, each patient is evaluated at T1 (+90 days) with Elastography, laboratory tests, clinical examination and T2 (+ 365 days) by a clinical examination.

Each center will prospectively collect data according to an electronic e-CFR on REDCap (Research Electronic Data Capture) system, a web application designed to support data capture for research studies in a secure manner.

Study duration: The study period will last approx. 730 days, with a planned follow-up of 365 days after surgical intervention

Keywords
liver stiffness, spleen stiffness, portal hypertension, liver cirrhosis, extrahepatic surgery, transient elastography, fibroscan
Medical subject headings
Hypertension, Portal, Liver Cirrhosis

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Early post-surgical (at +90 days) complications after extrahepatic surgery

    Complications related to the surgical procedure and/or liver disease after the extrahepatic elective surgery

    Measured: 90 days after surgery

Secondary outcomes (1)
  1. The liver-related events and overall survival at +90 days and + 360 days after extrahepatic surgery

    Liver-related events (decompensation, TIPS placement, liver transplantation) or death (liver e non-liver related) at 90 days 360 days from the elective extra-hepatic surgery

    Measured: 360 days after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Nov 2020
  2. Study start30 Aug 2020
  3. Primary completionOct 2021 (estimated)
  4. Study completionAug 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
250 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04615091
Sponsor's protocol ID
39512
Status last verified
Nov 2020
First submitted
18 Sep 2020
Last updated
4 Nov 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Uyei J, Taddei TH, Kaplan DE, Chapko M, Stevens ER, Braithwaite RS. Setting ambitious targets for surveillance and treatment rates among patients with hepatitis C related cirrhosis impacts the cost-effectiveness of hepatocellular cancer surveillance and substantially increases life expectancy: A modeling study. PLoS One. 2019 Aug 26;14(8):e0221614. doi: 10.1371/journal.pone.0221614. eCollection 2019.

    PubMed 31449554
  • Newman KL, Johnson KM, Cornia PB, Wu P, Itani K, Ioannou GN. Perioperative Evaluation and Management of Patients With Cirrhosis: Risk Assessment, Surgical Outcomes, and Future Directions. Clin Gastroenterol Hepatol. 2020 Oct;18(11):2398-2414.e3. doi: 10.1016/j.cgh.2019.07.051. Epub 2019 Jul 31.

    PubMed 31376494
  • Reverter E, Cirera I, Albillos A, Debernardi-Venon W, Abraldes JG, Llop E, Flores A, Martinez-Palli G, Blasi A, Martinez J, Turon F, Garcia-Valdecasas JC, Berzigotti A, de Lacy AM, Fuster J, Hernandez-Gea V, Bosch J, Garcia-Pagan JC. The prognostic role of hepatic venous pressure gradient in cirrhotic patients undergoing elective extrahepatic surgery. J Hepatol. 2019 Nov;71(5):942-950. doi: 10.1016/j.jhep.2019.07.007. Epub 2019 Jul 19.

    PubMed 31330170
  • Colecchia A, Ravaioli F, Marasco G, Colli A, Dajti E, Di Biase AR, Bacchi Reggiani ML, Berzigotti A, Pinzani M, Festi D. A combined model based on spleen stiffness measurement and Baveno VI criteria to rule out high-risk varices in advanced chronic liver disease. J Hepatol. 2018 Aug;69(2):308-317. doi: 10.1016/j.jhep.2018.04.023. Epub 2018 May 3.

    PubMed 29729368
  • Colecchia A, Montrone L, Scaioli E, Bacchi-Reggiani ML, Colli A, Casazza G, Schiumerini R, Turco L, Di Biase AR, Mazzella G, Marzi L, Arena U, Pinzani M, Festi D. Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis. Gastroenterology. 2012 Sep;143(3):646-654. doi: 10.1053/j.gastro.2012.05.035. Epub 2012 May 27.

    PubMed 22643348
  • Ma X, Wang L, Wu H, Feng Y, Han X, Bu H, Zhu Q. Spleen Stiffness Is Superior to Liver Stiffness for Predicting Esophageal Varices in Chronic Liver Disease: A Meta-Analysis. PLoS One. 2016 Nov 9;11(11):e0165786. doi: 10.1371/journal.pone.0165786. eCollection 2016.

    PubMed 27829057
  • Cescon M, Colecchia A, Cucchetti A, Peri E, Montrone L, Ercolani G, Festi D, Pinna AD. Value of transient elastography measured with FibroScan in predicting the outcome of hepatic resection for hepatocellular carcinoma. Ann Surg. 2012 Nov;256(5):706-12; discussion 712-3. doi: 10.1097/SLA.0b013e3182724ce8.

    PubMed 23095613
  • Marasco G, Colecchia A, Dajti E, Ravaioli F, Cucchetti A, Cescon M, Festi D. Prediction of posthepatectomy liver failure: Role of SSM and LSPS. J Surg Oncol. 2019 Mar;119(3):400-401. doi: 10.1002/jso.25345. Epub 2018 Dec 18. No abstract available.

    PubMed 30561034

Questions about this trial

What is this clinical trial studying?

An observational study of Advanced Chronic Liver Disease and Surgery--Complications, run by Azienda Ospedaliera Universitaria Integrata Verona at 37 sites in 12 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 4 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 37 sites in Italy, France, South Korea, Canada, Spain and 7 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact FEDERICO RAVAIOLI, MD; PhD (+393333176759, f.ravaioli@unibo.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Early post-surgical (at +90 days) complications after extrahepatic surgery (time frame: 90 days after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04615091, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2020.

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