Ischemia/Reperfusion Injury of Kidney, Ischemia/Reperfusion Injury of Liver Graft, Remote Ischemic Postconditioning
Conditions
Keywords
ischemia/reperfusion injury, remote ischemic postconditioning
Brief summary
The investigators are trying to evaluate the clinical effect of remote ischemic postconditioning on liver graft function and postoperative renal function in subjects undergoing living-donor liver transplantation.
Detailed description
Ischemic reperfusion injury of liver graft and postoperative renal dysfunction is a common problem which influence poor outcome in subjects undergoing liver transplantation. The incidence of postoperative renal dysfunction was reported as high as 12 \ 64% and is thought to be caused by ischemia/reperfusion injury. Ischemic pre- or postconditioning was reported to be effective for preventing ischemia/reperfusion injury during liver transplantation. Remote ischemic pre- or postconditioning was also reported to be protective for ischemia/reperfusion injury in major organs in previous animal studies. Therefore, we are trying to evaluate the clinical effect of remote ischemic postconditioning on liver graft function and postoperative renal function in subjects undergoing living-donor liver transplantation.
Interventions
OTHERRIPC
Those undergoing remote ischemic postconditioning. Remote ischemic postconditioning consists of three 5-min cycles of upper limb ischemia, which was induced by an automated cuff-inflator placed on the unilateral upper limb 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
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Subjects undergoing living donor liver transplantation during the study period * Subjects older than 20 yrs who can give written informed consent
Exclusion criteria
* Re-transplanted recipients * Those with peripheral vascular diseases affecting the extremities * Those with hepatic encephalopathy * Those with cirrhotic cardiomyopathy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| total bilirubin | before surgery and at 6, 12, 24, 36, 48, 60, 72, 84, 96 hours after the end of surgery | total bilirubin before surgery and at 6, 12, 24, 36, 48, 60, 72, 84, 96 hours after the end of surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Renal Function Test profiles | Before surgery and at 6, 12, 24, 36, 48, 60, 72, 84, 96 hours after the end of surgery | Serum BUN, creatinine concentration, estimated GFR and urine output before surgery and at 6, 12, 24, 36, 48, 60, 72, 84, 96 hours after the end of surgery |
| Liver Function Test Profiles | before surgery and at 6, 12, 24, 36, 48, 60, 72, 84, 96 hours after the end of surgery | AST, ALT, albumin, before surgery and at 6, 12, 24, 36, 48, 60, 72, 84, 96 hours after the end of surgery |
| incidence of Surgical Outcome | 1 week, 1 month after the end of surgery | incidence of acute rejection of transplanted Liver (Biopsy-confirmed or clinically symptomatic),incidence of Delayed graft function : clinically symptomatic, incidecne of Postoperative renal replacement therapy |
| Length of hospital stay (days) | 1 month, 2 month, 3 month after the end of surgery | total hospital stay, ICU stay, postoperative stay |
Countries
South Korea
Outcome results
None listed