REFIL-2: Effects of an intraoperative low-splanchnic blood volume restrictive fluid management strategy compared to a cardiac output optimized liberal fluid management strategy on postoperative outcomes in liver transplantation: A multicenter randomized controlled trial
Liver transplant recipients often experience complications after surgery, which can delay recovery and affect quality of life. Currently, there is no clear consensus on the best way to manage fluid administration and blood pressure during surgery to reduce these risks.
This study aims to identify the approach that leads to fewer complications and better recovery.
The study will compare two commonly used intraoperative strategies during liver transplantation:
A restrictive approach, involving the removal of a small amount of blood at the start of surgery and limited fluid administration, only when necessary
A liberal approach, with no blood removal and more generous fluid administration Participants will be randomly assigned to one of these two approaches.
Outcomes have been selected in collaboration with patient partners and include severe postoperative complications, early recovery, quality of life at 6 and 12 months, survival up to one year, and healthcare resource use.
A total of 866 patients will be recruited across multiple centers in Canada and France.
This study will help identify the most effective intraoperative strategy to improve patient outcomes after liver transplantation. The results are expected to inform clinical guidelines and support more consistent, patient-centered care.
