Donor HepatectomyNCT07723391
Effect of Preoperative Carbohydrate Loading on Serum Lactate Levels in Patients Undergoing Donor Hepatectomy
A study testing Preoperative Carbohydrate Loading in people with Donor Hepatectomy and Serum Lactate, run by Shifa International Hospital at 1 site in Pakistan.
Trial summary
This randomized controlled trial investigated whether preoperative carbohydrate loading reduces perioperative serum lactate levels in patients undergoing donor hepatectomy. Participants were randomized into two groups: an intervention group receiving a standardized oral carbohydrate drink 2-4 hours before surgery, and… Read more about this study
- Who is it for?
- Ages 18 to 50 yearsHealthy volunteers can take part
- Conditions the study is for
- Donor Hepatectomy, Serum Lactate, Preoperative Carbohydrate Loading
- What is being tested?
- Preoperative Carbohydrate Loading
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 70 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Dec 2024to 30 Aug 2025
- Phase
- Interventional
- 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 to 50 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Age 18 to 50 years Either gender Scheduled for elective donor hepatectomy
Who cannot join
- Known metabolic disorders Pre-existing liver dysfunction
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effect of Preoperative Carbohydrate Loading on Perioperative Serum Lactate Levels in Patients Undergoing Donor Hepatectomy: A Randomized Controlled Trial
This randomized controlled trial investigated whether preoperative carbohydrate loading reduces perioperative serum lactate levels in patients undergoing donor hepatectomy. Participants were randomized into two groups: an intervention group receiving a standardized oral carbohydrate drink 2-4 hours before surgery, and a control group undergoing standard preoperative fasting. Serum lactate levels were measured at five perioperative time points: induction of anaesthesia, before graft removal, 30 minutes after graft removal, before extubation, and in the post-anaesthesia care unit. The study aimed to determine whether this simple nutritional intervention could improve metabolic preparedness and reduce anaerobic stress in living liver donors.
Read the detailed description
Prolonged preoperative fasting induces peripheral insulin resistance, glycogen depletion, and a catabolic metabolic state that predisposes patients to anaerobic metabolism during major surgery. Donor hepatectomy is a physiologically demanding procedure associated with significant ischaemia-reperfusion stress and an inherent risk of perioperative lactate accumulation.
Preoperative carbohydrate loading has been proposed as a simple nutritional intervention to attenuate fasting-related metabolic stress by preserving glycogen stores and improving insulin sensitivity. However, its specific effect on serum lactate levels in living liver donors undergoing donor hepatectomy remains underexplored.
This prospective randomized controlled trial was conducted at the Department of Anaesthesiology, Shifa International Hospital, Islamabad. Seventy adult patients aged 18-50 years scheduled for elective donor hepatectomy were enrolled and randomized into two equal groups. The intervention group received a standardized oral carbohydrate drink (maltodextrin solution) 2-4 hours before surgery, while the control group underwent standard preoperative fasting. Serum lactate levels were measured at five perioperative time points. Between-group comparisons were performed using the Mann-Whitney U test, and temporal trends were assessed using repeated measures ANOVA.
- Being tested
- Preoperative Carbohydrate Loading
- Keywords
- Carbohydrate loading, Donor hepatectomy, Serum lactate, Perioperative metabolic optimization, ERAS, Living donor liver transplantation, Preoperative fasting, Insulin resistance
- Medical subject headings
- Insulin Resistance
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Preoperative Carbohydrate LoadingDietary supplement
Standardized oral carbohydrate drink (maltodextrin solution) administered 2-4 hours prior to induction of anaesthesia
| Study group | Role | What they receive |
|---|---|---|
| Intervention Group | Experimental | Participants received a standardized oral carbohydrate drink (maltodextrin solution) 2-4 hours before induction of anaesthesia Receives: Dietary Supplement: Preoperative Carbohydrate Loading |
| Control Group | No intervention | Participants underwent standard preoperative fasting protocol without carbohydrate loading |
What is being measured
The primary outcome is the main question the study is designed to answer.
Perioperative Serum Lactate Level
Serum lactate measured in mmol/L at five perioperative time points: induction of anaesthesia, before graft removal, 30 minutes post graft removal, before extubation, and in the post-anaesthesia care unit (PACU)
Measured: From induction of anaesthesia through to PACU (approximately 6-8 hours)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Jul 2026
- Study start1 Dec 2024
- Primary completion30 Aug 2025
- Study completion30 Aug 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Donor HepatectomyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 70 participants (actual)
Sponsor and investigators
- Lead sponsor
- Shifa International Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mian Usman Hameed, Shifa International Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07723391
- Sponsor's protocol ID
- IRB 479-24
- Status last verified
- Jul 2026
- First submitted
- 20 Jul 2026
- Last updated
- 23 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Kumar M, Patil NS, Mohapatra N, Yadav A, Sindwani G, Dhingra U, Thomas S, Pamecha V. Preoperative carbohydrate loading reduces perioperative insulin resistance and hastens functional recovery of remnant liver after living donor hepatectomy: An open-label randomized controlled trial. Hepatol Int. 2025 Oct;19(5):1151-1161. doi: 10.1007/s12072-025-10831-5. Epub 2025 May 19.
PubMed 40389625Recknagel S, Rademacher S, Hohne C, Lederer AA, Lange UG, Herta T, Seehofer D, Sucher R, Scheuermann U. Prediction of the Postoperative Outcome in Liver Resection Using Perioperative Serum Lactate Levels. J Clin Med. 2023 Mar 7;12(6):2100. doi: 10.3390/jcm12062100.
PubMed 36983103Baumgartner R, Engstrand J, Rajala P, Grip J, Ghorbani P, Sparrelid E, Gilg S. Comparing the accuracy of prediction models to detect clinically relevant post-hepatectomy liver failure early after major hepatectomy. Br J Surg. 2024 Jan 3;111(1):znad433. doi: 10.1093/bjs/znad433.
PubMed 38150185Zhang Y, Min J. Preoperative Carbohydrate Loading in Gynecological Patients Undergoing Combined Spinal and Epidural Anesthesia. J Invest Surg. 2020 Aug;33(7):587-595. doi: 10.1080/08941939.2018.1546352. Epub 2019 Jan 15.
PubMed 30644785Kumar SM, Anandhi A, Sureshkumar S, Keerthi AR, Raja K, Jha AK, Bobby Z, Kate V. Effect of preoperative oral carbohydrate loading on postoperative insulin resistance, patient-perceived well-being, and surgical outcomes in elective colorectal surgery: a randomized controlled trial. J Gastrointest Surg. 2024 Oct;28(10):1654-1660. doi: 10.1016/j.gassur.2024.07.027. Epub 2024 Aug 12.
PubMed 39142436Joshi GP, Abdelmalak BB, Weigel WA, Harbell MW, Kuo CI, Soriano SG, Stricker PA, Tipton T, Grant MD, Marbella AM, Agarkar M, Blanck JF, Domino KB. 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration-A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting. Anesthesiology. 2023 Feb 1;138(2):132-151. doi: 10.1097/ALN.0000000000004381.
PubMed 36629465Crowley K, Scanaill PO, Hermanides J, Buggy DJ. Current practice in the perioperative management of patients with diabetes mellitus: a narrative review. Br J Anaesth. 2023 Aug;131(2):242-252. doi: 10.1016/j.bja.2023.02.039. Epub 2023 Apr 13.
PubMed 37061429Tong E, Chen Y, Ren Y, Zhou Y, Di C, Zhou Y, Shao S, Qiu S, Hong Y, Yang L, Tan X. Effects of preoperative carbohydrate loading on recovery after elective surgery: A systematic review and Bayesian network meta-analysis of randomized controlled trials. Front Nutr. 2022 Nov 23;9:951676. doi: 10.3389/fnut.2022.951676. eCollection 2022.
PubMed 36505254Joliat GR, Kobayashi K, Hasegawa K, Thomson JE, Padbury R, Scott M, Brustia R, Scatton O, Tran Cao HS, Vauthey JN, Dincler S, Clavien PA, Wigmore SJ, Demartines N, Melloul E. Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022. World J Surg. 2023 Jan;47(1):11-34. doi: 10.1007/s00268-022-06732-5. Epub 2022 Oct 30.
PubMed 36310325
Study at a glance
From the registry record, last updated by the sponsor on 23 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Preoperative Carbohydrate Loading on Perioperative Serum Lactate Levels in Patients Undergoing Donor Hepatectomy: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07723391
- Acronym / sponsor ID
- IRB 479-24
- Keywords
- Carbohydrate loading, Donor hepatectomy, Serum lactate, Perioperative metabolic optimization, ERAS, Living donor liver transplantation, Preoperative fasting, Insulin resistance
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 70 participants (actual)
- Lead sponsor
- Shifa International HospitalUniversity, hospital or other
- Study start
- 1 Dec 2024 (actual)
- Primary completion
- 30 Aug 2025 (actual)
- Study completion
- 30 Aug 2025 (actual)
- First posted
- 23 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized controlled trial investigated whether preoperative carbohydrate loading reduces perioperative serum lactate levels in patients undergoing donor hepatectomy. Participants were randomized into two groups: an intervention group receiving a standardized oral carbohydrate drink 2-4 hours before surgery, and a control group undergoing standard preoperative fasting. Serum lactate levels were measured at five perioperative time points: induction of anaesthesia, before graft removal, 30 minutes after graft removal, before extubation, and in the post-anaesthesia care unit. The study aimed to determine whether this simple nutritional intervention could improve metabolic preparedness and reduce anaerobic stress in living liver donors.
Detailed description
Prolonged preoperative fasting induces peripheral insulin resistance, glycogen depletion, and a catabolic metabolic state that predisposes patients to anaerobic metabolism during major surgery. Donor hepatectomy is a physiologically demanding procedure associated with significant ischaemia-reperfusion stress and an inherent risk of perioperative lactate accumulation.
Preoperative carbohydrate loading has been proposed as a simple nutritional intervention to attenuate fasting-related metabolic stress by preserving glycogen stores and improving insulin sensitivity. However, its specific effect on serum lactate levels in living liver donors undergoing donor hepatectomy remains underexplored.
This prospective randomized controlled trial was conducted at the Department of Anaesthesiology, Shifa International Hospital, Islamabad. Seventy adult patients aged 18-50 years scheduled for elective donor hepatectomy were enrolled and randomized into two equal groups. The intervention group received a standardized oral carbohydrate drink (maltodextrin solution) 2-4 hours before surgery, while the control group underwent standard preoperative fasting. Serum lactate levels were measured at five perioperative time points. Between-group comparisons were performed using the Mann-Whitney U test, and temporal trends were assessed using repeated measures ANOVA.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Intervention Group | Experimental | Dietary Supplement: Preoperative Carbohydrate LoadingParticipants received a standardized oral carbohydrate drink (maltodextrin solution) 2-4 hours before induction of anaesthesia |
| Control Group | No intervention | –Participants underwent standard preoperative fasting protocol without carbohydrate loading |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- Age 18 to 50 years Either gender Scheduled for elective donor hepatectomy
Key exclusion criteria (1 listed)
- Known metabolic disorders Pre-existing liver dysfunction
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Preoperative Carbohydrate LoadingStandardized oral carbohydrate drink (maltodextrin solution) administered 2-4 hours prior to induction of anaesthesia | Dietary supplement | Intervention Group |
Primary outcome
Perioperative Serum Lactate Level
Time frame: From induction of anaesthesia through to PACU (approximately 6-8 hours)
Serum lactate measured in mmol/L at five perioperative time points: induction of anaesthesia, before graft removal, 30 minutes post graft removal, before extubation, and in the post-anaesthesia care unit (PACU)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Jul 2026.
- Background: PubMed 40389625Kumar M, Patil NS, Mohapatra N, Yadav A, Sindwani G, Dhingra U, Thomas S, Pamecha V. Preoperative carbohydrate loading reduces perioperative insulin resistance and hastens functional recovery of remnant liver after living donor hepatectomy: An open-label randomized controlled trial. Hepatol Int. 2025 Oct;19(5):1151-1161. doi: 10.1007/s12072-025-10831-5. Epub 2025 May 19.
- Background: PubMed 36983103Recknagel S, Rademacher S, Hohne C, Lederer AA, Lange UG, Herta T, Seehofer D, Sucher R, Scheuermann U. Prediction of the Postoperative Outcome in Liver Resection Using Perioperative Serum Lactate Levels. J Clin Med. 2023 Mar 7;12(6):2100. doi: 10.3390/jcm12062100.
- Background: PubMed 38150185Baumgartner R, Engstrand J, Rajala P, Grip J, Ghorbani P, Sparrelid E, Gilg S. Comparing the accuracy of prediction models to detect clinically relevant post-hepatectomy liver failure early after major hepatectomy. Br J Surg. 2024 Jan 3;111(1):znad433. doi: 10.1093/bjs/znad433.
- Background: PubMed 30644785Zhang Y, Min J. Preoperative Carbohydrate Loading in Gynecological Patients Undergoing Combined Spinal and Epidural Anesthesia. J Invest Surg. 2020 Aug;33(7):587-595. doi: 10.1080/08941939.2018.1546352. Epub 2019 Jan 15.
- Background: PubMed 39142436Kumar SM, Anandhi A, Sureshkumar S, Keerthi AR, Raja K, Jha AK, Bobby Z, Kate V. Effect of preoperative oral carbohydrate loading on postoperative insulin resistance, patient-perceived well-being, and surgical outcomes in elective colorectal surgery: a randomized controlled trial. J Gastrointest Surg. 2024 Oct;28(10):1654-1660. doi: 10.1016/j.gassur.2024.07.027. Epub 2024 Aug 12.
- Background: PubMed 36629465Joshi GP, Abdelmalak BB, Weigel WA, Harbell MW, Kuo CI, Soriano SG, Stricker PA, Tipton T, Grant MD, Marbella AM, Agarkar M, Blanck JF, Domino KB. 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration-A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting. Anesthesiology. 2023 Feb 1;138(2):132-151. doi: 10.1097/ALN.0000000000004381.
- Background: PubMed 37061429Crowley K, Scanaill PO, Hermanides J, Buggy DJ. Current practice in the perioperative management of patients with diabetes mellitus: a narrative review. Br J Anaesth. 2023 Aug;131(2):242-252. doi: 10.1016/j.bja.2023.02.039. Epub 2023 Apr 13.
- Background: PubMed 36505254Tong E, Chen Y, Ren Y, Zhou Y, Di C, Zhou Y, Shao S, Qiu S, Hong Y, Yang L, Tan X. Effects of preoperative carbohydrate loading on recovery after elective surgery: A systematic review and Bayesian network meta-analysis of randomized controlled trials. Front Nutr. 2022 Nov 23;9:951676. doi: 10.3389/fnut.2022.951676. eCollection 2022.
- Background: PubMed 36310325Joliat GR, Kobayashi K, Hasegawa K, Thomson JE, Padbury R, Scott M, Brustia R, Scatton O, Tran Cao HS, Vauthey JN, Dincler S, Clavien PA, Wigmore SJ, Demartines N, Melloul E. Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022. World J Surg. 2023 Jan;47(1):11-34. doi: 10.1007/s00268-022-06732-5. Epub 2022 Oct 30.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Preoperative Carbohydrate Loading in people with Donor Hepatectomy and Serum Lactate, run by Shifa International Hospital at 1 site in Pakistan.
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 1 inclusion and 1 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: finished, as of the sponsor's last update on 23 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Perioperative Serum Lactate Level (time frame: From induction of anaesthesia through to PACU (approximately 6-8 hours)). 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 NCT07723391, which also lists 9 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 23 Jul 2026.