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RecruitingNCT06814626NS-TIPSUpdated Jul 14, 2026

Role of Nutritional Intervention for the Treatment of Sarcopenia in Cirrhotic Patients With Refractory Ascites Candidate to Transjugular Intrahepatic Portosystemic Shunt Placement and Identification of Prognostic Factors Related to Clinical Outcome

A Phase 3 interventional study of 12-week nutritional intervention with Friliver dispensing and 12-week nutritional intervention with personalized diet in Liver Cirrhosis, Refractory Ascites in Patients With Cirrhosis and Sarcopenia in Liver Cirrhosis, sponsored by The Mediterranean Institute for Transplantation and Advanced Specialized Therapies. Recruiting at 2 sites in 2 countries. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-07-14.

Sponsored by The Mediterranean Institute for Transplantation and Advanced Specialized Therapies · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Registered 2 years 3 months after the study started (first participant enrolled Oct 2022, registered Jan 2025).
  • Started Oct 2022; still recruiting 4 years later.
Phase
Phase 3
Study type
Interventional
Enrollment
72
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The hypothesis is that in patients with cirrhosis and refractory ascites candidate to TIPS, and sarcopenia (identified by a PMA ≤16 cm² at the level of L3), who are at high-risk of 6-month mortality after TIPS placement, a post-TIPS 12 weeks nutritional intervention is associated with improved post-TIPS prognosis.

The primary objective is to evaluate the effect of a post-TIPS 12 weeks nutritional intervention on liver transplant-free six-month survival in sarcopenic candidates to TIPS for refractory ascites in cirrhosis.

02

Conditions studied

  • Liver Cirrhosis
  • Refractory Ascites in Patients With Cirrhosis
  • Sarcopenia in Liver Cirrhosis

Keywords

  • nutritional treatment
  • sarcopenia
  • liver cirrhosis
  • refractory ascites
  • transjugular intrahepatic portosystemic shunt placement
  • TIPS
03

In context

Liver Cirrhosis

1,298 studies on the registry are indexed under Liver Cirrhosis; 338 are open to participants now.

This study's planned enrollment of 72 is close to the median of 78 across 739 interventional studies indexed under Liver Cirrhosis.

Browse Liver Cirrhosis studies →

Lead sponsor

The Mediterranean Institute for Transplantation and Advanced Specialized Therapies is the lead sponsor of 13 studies on the registry; 7 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • men and women with an age ≥ 18 and ≤ 80 years
  • clinical, radiological or histological diagnosis of liver cirrhosis
  • diagnosis of RA
  • confirmation of sarcopenia defined in CT scan as the sum of the psoas muscle areas measured at the level of the 3rd lumbar vertebra (PMA) ≤16 cm2
  • signed

Exclusion criteria

Exclusion Criteria:

  • severe hepatic insufficiency (> 5 mg/dl, MELD score> 18, score> 9)
  • Congestive heart failure class ≥2 according to criteria (NYHA)
  • Active coronary heart disease (myocardial infarction within 6 months of the study)
  • Severe pulmonary hypertension suspected on echocardiogram (systolic pulmonary arterial pressure [PAPs]> 35 mmHg) and confirmed with right cardiac catheterization (PAPs> 45mmHg)
  • Chronic renal failure (creatinine> 3 mg/dl)
  • Performance status ≥2 according to the scale (ECOG)
  • History of grade III-IV hepatic encephalopathy or West Haven grade I-II hepatic encephalopathy episodes within the last 3 months
  • Uncontrolled systemic sepsis
  • Presence of Hepatocellular carcinoma
  • Complete portal vein thrombosis
  • Active bleeding from gastroesophageal varices. Patients with adequately treated gastroesophageal varices can be included in the study (banding ligation, sclerotherapy)
  • Diagnosis of extra hepatic neoplasia
  • Transplant recipients
  • Patients unable or unwilling to comply with the protocol requirements
  • Pregnant or lactating women
  • Patients unable to autonomously express their consent (incapable patients)
  • any other laboratory condition or result that in the opinion of the Principal Investigator, preclude the subject's participation in the study
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
72 participants (estimated)

Study arms

  • Experimental
    12 weeks post-TIPS nutritional dietary intervention

    Dietary Supplement: 12-week nutritional intervention with Friliver dispensing · Other: 12-week nutritional intervention with personalized diet · Other: 12-week nutritional intervention with diet diary to report foods eaten.

  • No intervention
    Standard clinical practice: follow-up post-TIPS placement.

Interventions

  • Dietary supplement12-week nutritional intervention with Friliver dispensing

    After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

  • Other12-week nutritional intervention with personalized diet

    After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

  • Other12-week nutritional intervention with diet diary to report foods eaten.

    After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

06

What researchers measure

Primary outcomes

  1. Rate of survival at 6 months after TIPS assessed using Kaplan-Meier curves. The difference between the survival of the two groups (control and treatment) will be calculated using a Log-Rank test.

    Time frame: From enrollment to 6 months after TIPS.

07

Study locations

2 of 2 sites recruiting
  • IRCCS ISMETT - Istituto Mediterraneo per i Trapianti e le Terapie ad Alta Specializzazione
    Palermo, 90127, Italy
    Recruiting
  • University Clinic for Visceral Surgery and Medicine, Inselspital
    Bern, 3010, Switzerland
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 14, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06814626
Lead sponsor
The Mediterranean Institute for Transplantation and Advanced Specialized Therapies
Responsible party
Sponsor
First posted
Feb 7, 2025
Start date
Oct 13, 2022
Primary completion
Dec 2027 (estimated)
Completion
Dec 2027 (estimated)
Last update
Jul 14, 2026

Study contacts

Angelo Luca, Radiologist
Contact
aluca@ismett.edu
+39 0912192468
Monica Rizzo, Study Coordinator
Contact
morizzo@ismett.edu
+39 0912192692

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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