Ischemic Reperfusion Injury, Kidney Transplantation, Remote Ischemic Postconditioning
Conditions
Brief summary
The purpose of this study is to investigate whether upper limb ischemic postconditioning can improve renal function and decrease ischemic-reperfusion injury in patients undergoing living donor kidney transplantation.
Detailed description
Ischemic reperfusion injury after kidney transplantation is a common clinical problem associated with a high morbidity and mortality. To reduce the adverse effect of ischemic reperfusion injury after organ transplantation, various strategies including ischemic preconditioning or postconditioning. Remote ischemic postconditioning is one of such strategies where brief ischemic reperfusion injury of one organ protects other organs from sustained ischemic reperfusion injury. Remote ischemic postconditioning of the limb with a tourniquet is a safe and convenient method of postconditioning organs against ischemic reperfusion injury. However, the efficacy of remote ischemic postconditioning in patients undergoing living donor kidney transplantation needs to be established. Therefore, we investigate the efficacy of remote ischemic postconditioning of the upper limb with a tourniquet in recipients of kidney transplantation by measuring the markers of acute kidney injury.
Interventions
Remote ischemic postconditioning consists of three 5-min cycles of upper limb ischemia, which was induced by an automated cuff-inflator placed on the upper limb free of arteriovenous fistula and inflated to 250 mm Hg, with an intervening 5 min of reperfusion during which the cuff was deflated.
Sponsors
Samsung Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Subjects undergoing elective living donor kidney transplantation * subjects older than 20 yrs who can give written informed consent
Exclusion criteria
* re-transplant recipients * those with peripheral vascular disease affecting the upper limbs free of arteriovenous fistula
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| renal function of recipient after living-related kidney transplantation | 1 day before surgery | serum creatinine concentration and urine output |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Biomarkers of acute kidney injury | before surgery and at 2, 6, 12 h after declaming of renal artery | biomarkers of acute kidney injury: Plasma cystatin-C, Urine IL-18, Urine Neutrophil gelatinase-associated lipocalin (NGAL) |
| Hemodynamic parameters | before surgery and at 2, 6, 12, 24, 48, 72 h after declaming of renal artery | arterial blood pressure, heart rate, central venous pressure, pulse oximetry |
| outcome of kidney transplantation | at 72 h after declaming of renal artery | number of acute rejection or number of delayed graft function |
| postoperative hospital stay | at postoperative day 60 | length of postoperative hospital stay (days) |
Countries
South Korea
Outcome results
None listed