Hydroxocobalamin as a New and Possibly Superior Treatment for Refractory Vasoplegic Syndrome during Liver Transplant Surgery


About this study

The purpose of this study is to evaluate if Hydroxocobalamin may be a new and possibly superior treatment for refractory vasoplegic syndrome during liver transplant surgery.



Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Age ≥ 18 years old.
  • Patients scheduled to undergo liver transplantation.
  • Patients able to read and understand consent document (if patient is unable to provide an informed consent, the Legally Authorized Representative will be ask to consent on behalf of the patient).
  • SVR lower than 500 dynes-sec/cm–5 sustained for more than 5 minutes despite the administration of vasopressors intraoperatively (this criterion must be met after consent intraoperatively).

Exclusion Criteria: 


  • Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency documented as a medical history.
  • Patients taking serotonergic drugs such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs).
  • Patients with allergy to methylene blue or hydroxocobalamin.


Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Jacksonville, Fla.

Mayo Clinic principal investigator

Sher-Lu Pai, M.D.

Closed for enrollment

Contact information:

Karina Hex CCRP


More information


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