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Trial registered on ANZCTR
Registration number
ACTRN12613000802707
Ethics application status
Approved
Date submitted
16/07/2013
Date registered
19/07/2013
Date last updated
15/03/2019
Date data sharing statement initially provided
15/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Bleeding and clotting complications in patients having liver surgery
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Scientific title
An observational thromboelastography study to explore the impact of liver surgery on coagulation profile, bleeding events, thromboembolic events and endothelial function in patients undergoing hepatic resection at Peter MacCallum Cancer Centre
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Secondary ID [1]
282832
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
CLOTS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Liver resection
289616
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Bleeding
289617
0
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Thrombosis
289618
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Endothelial Function
289619
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Condition category
Condition code
Blood
289954
289954
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0
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Clotting disorders
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Cancer
289975
289975
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0
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Liver
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This is an observational study of patients undergoing hepatic resection to characterise the changes to coagulation which are experienced and correlate these with patient, perioperative and surgical factors.
Patients will be observed from the day of surgery until 1 year post surgery with review points at: Day 1, Day 3, Day 5 (if certain conditions met), week 2-3 (clinic review time), week 4-6 (clinic review time) and 1 year (clinic review time).
At the 1 year review only survival status, cancer recurrence and reporting of any further bleeding or clotting events will be recorded. No blood tests or endothelial assessment will occur at 1 year.
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Intervention code [1]
287523
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Not applicable
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Comparator / control treatment
Nil - prospective cohort study
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Identify predictive thrombogenic biomarkers, to assess changes throughout the perioperative period in patients undergoing hepatic resection.
Biomarkers will include: Coagulation profile (APTT, PT, INR, Fibrinogen, D-dimer), Thromboelastograph (TEG - Registered Trademark), vWF, FVIIIc, TM, TATC, PF1 + 2, Fibrin monomers
Detection of bleeding and clotting events will be by routine clinical investigations directed by the treating team (observation, ultrasonography, CT scanning etc)
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Assessment method [1]
290008
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Timepoint [1]
290008
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Day of surgery to day 3 post surgery
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Secondary outcome [1]
303764
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Determine the temporal pattern of thromboembolism and bleeding events throughout the perioperative period for hepatic resection surgery
Detection of bleeding and clotting events will be by routine clinical investigations directed by the treating team if indicated (observation, ultrasonography, CT scanning etc)
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Assessment method [1]
303764
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Timepoint [1]
303764
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Day of surgery until 6 weeks post surgery
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Secondary outcome [2]
303765
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Develop a thromboembolism risk-model from clinical and thrombogenic biomarkers, for prospective validation and incorporation into risk-targeted thromboprophylaxis guidelines appropriate for hepatic resection
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Assessment method [2]
303765
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Timepoint [2]
303765
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Day of surgery until 6 weeks post surgery
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Secondary outcome [3]
303766
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Investigate endothelial function in patients undergoing hepatic resection for cancer
Assessment will involve the use of the EndoPAT non-invasive finger probe
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Assessment method [3]
303766
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Timepoint [3]
303766
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Day of surgery until day 3 post surgery
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Eligibility
Key inclusion criteria
Adult patients undergoing hepatic resection for malignancy
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Minimum age
18
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Refusal
Clinical indication for anticoagulation perioperatively (except aspirin)
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
The sample size is a pragmatic sample based on the caseload at Peter MacCallum Cancer Centre and the funding available for the thrombogenic biomarker assays and a reasonable belief that these results will be meaningful.
Descriptive statistics in addition to multivariable regression methods to explore the relationships between coagulation markers and clinical factors
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2013
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Actual
14/08/2013
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Date of last participant enrolment
Anticipated
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Actual
24/06/2015
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Date of last data collection
Anticipated
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Actual
27/06/2016
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Sample size
Target
50
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Accrual to date
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Final
52
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
1280
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Peter MacCallum Cancer Institute - East Melbourne
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Funding & Sponsors
Funding source category [1]
287617
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Charities/Societies/Foundations
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Name [1]
287617
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Feilman foundation
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Address [1]
287617
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1 William Street, Perth WA 6000
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Country [1]
287617
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Australia
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Primary sponsor type
Individual
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Name
Dr Megan L Allen
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Address
Department of Anaesthesia
Peter MacCallum Cancer Centre
East Melbourne
Locked Bag 1, A'Beckett Street VIC Australia 8006
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Country
Australia
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Secondary sponsor category [1]
286361
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None
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Name [1]
286361
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Address [1]
286361
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Country [1]
286361
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
289588
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Ethics Committee Secretariat
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Ethics committee address [1]
289588
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Peter MacCallum Cancer Centre East Melbourne Locked Bag 1, A'Beckett Street VIC Australia 8006
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Ethics committee country [1]
289588
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Australia
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Date submitted for ethics approval [1]
289588
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Approval date [1]
289588
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11/07/2013
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Ethics approval number [1]
289588
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13_52L
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Summary
Brief summary
This is an observational study evaluating bleeding and clotting complications in patients undergoing liver surgery for cancer. Who is it for? You may be eligible to join this study if you are aged 18 years or above and are undergoing hepatic resection (i.e. surgical removal of all or a portion of the liver) for malignancy at Peter MacCallum Cancer Centre. Study details Changes to the blood clotting system following liver surgery have not been well characterised and information is conflicting. The traditional view is that as the liver makes important clotting factors surgery would reduce this production and make patients more likely to bleed. However, some recent work has suggested that actually liver resection patients are prone to blood clotting and the bigger the surgery the higher the risk. This study aims to use laboratory tests of coagulation to determine what actually occurs. Patients will be observed from the day of surgery until 1 year post surgery with review points at: Day 1, Day 3, Day 5 (if certain conditions met), week 2-3 (clinic review time), week 4-6 (clinic review time) and 1 year (clinic review time). Data collected from this study will help us to develop guidelines for management of blood clotting around the time of liver surgery. Additionally, the rate of bleeding and clotting complications will also be recorded.
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Trial website
Nil
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Megan Allen
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Address
41438
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Department of Anaesthesia
Peter MacCallum Cancer Centre
East Melbourne
Locked Bag 1, A'Beckett Street VIC Australia 8006
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Country
41438
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Australia
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Phone
41438
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+61 3 9656 1111
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Fax
41438
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Email
41438
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[email protected]
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Contact person for public queries
Name
41439
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Megan Allen
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Address
41439
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Department of Anaesthesia
Peter MacCallum Cancer Centre
East Melbourne
Locked Bag 1, A'Beckett Street VIC Australia 8006
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Country
41439
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Australia
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Phone
41439
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+61 3 9656 1111
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Fax
41439
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Email
41439
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[email protected]
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Contact person for scientific queries
Name
41440
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Megan Allen
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Address
41440
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Department of Anaesthesia
Peter MacCallum Cancer Centre
East Melbourne
Locked Bag 1, A'Beckett Street VIC Australia 8006
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Country
41440
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Australia
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Phone
41440
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+61 3 9656 1111
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Fax
41440
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Email
41440
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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