Evidence of Liver Transplantation
Conditions
Keywords
Ischemia-Reperfusion Injury, oxidative stress, organ preservation, Hydrogen, Kidney Transplantation
Brief summary
The purpose of this study is to investigate whether hydrogen-rich Celsior solution improve the quality of aging grafts in liver/kidney transplantation.
Detailed description
The organ shortage has been rising to impede the development of organ transplantation.To find a solution, transplantation center is working on the application of marginal grafted liver or renal, especially the aging grafts. The most common inducement of organ dysfunction during the perioperation is liver/renal ischemia-reperfusion (I/R) injury, caused by the generation of cytotoxic oxygen radicals. Hydrogen gas is a kind of reducing gas, which has been reported to display antioxidant properties and protective effects against organ dysfunction induced by various I/R injuries. Investigators will investigate whether hydrogen-rich Celsior solution improve the quality of aging grafts in liver/ kidney transplantation.
Interventions
DRUGHydrogen-Rich Celsior Solution
Before the procedure, add hydrogen gas into Celsior solution. After harvesting the liver/kidney grafts, lavage and cold store the grafts with Hydrogen-Rich Celsior Solution.
Sponsors
RenJi Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Donors: 1. Age of the donor ≥60 yrs. 2. The donor has no historical records of drug abuse, alcoholic abuse, homosexual,or drug addiction, etc. 3. Evaluate infections and infectious disease of the donor. 4. History of malignant tumor; 5. History of hypertension, diabetes, hemophilia, or other anticoagulant disease,kidney donor should not have a history of kidney disease. 6. Daily urine volume is approximately normal. 7. Donor should be subjected to physical examination by medical doctor of OPO stuff before donation; the OPO stuff should realize whether the potential donor has infected lesion or not, such as abscess, ulcer, lymphadenectasis， etc., and evaluate infectious risk of recipient post-operationally. 8. OPO stuff should realize the dynamic change of body temperature, as well as various intensive care parameters of the potential donor, it shall be very important to be sure whether the potential donor has pulmonary/ systemic infections or not,especially for whom has longer ICU duration (\> 7 Days). 9. The potential donor should has a systolic blood pressure ≥ 50 mm Hg (1mmHg=0.133 kPa) and arterial SaO \> 80%. 10. Liver Biochemistry: alanine aminotransferase (ALT) ≤ 6ULN, total bilirubin (TBil) ≤ 50umol/L;Kidney Biochemistry: serum creatinine (sCre) ≤ 2ULN; 11. Negative anti-HIV antibody; 12. Negative bacterial and fungal culture in blood; 13. Ultrasonic diagnosis of fatty liver, trauma, hematoma, lithiasis, etc., as well as size of both kidney, hydronephrosis, nephrolithiasis, etc. if possible. 14. Graft liver should be soft, normal color and even, no tumor or other abnormity;steatosis ≤ 30% by liver biopsy.Graft kidneys should have complete renal capsule with no congestion or bleeding;proximal tubular necrosis ≤ 50%, without obvious structural damage.Organ (liver and kidney) cold ischemia time (CIT) is determined as the time duration from cold preservation of organs to transplant re-perfusion. CIT of aging DBD liver and kidney graft should be ≤ 10 and16 hours, respectively. Recipients： 1. Aged between 18-65 years old 2. MELD score ≤25,BMI≤25 3. Patients with tumor,the expected lifetime≥6 months 4. Agree to anticipate the trial and sign the informed consent
Exclusion criteria
* Donor's age \< 60 yrs; * The donor has historical records of drug abuse, alcoholic abuse, homosexual, or drug addiction, etc. * The donor is HIV infected, or has severe infection, or positive bacterial and/ or fungal culture results; * Uncontrollable hypertension, diabetics; * Malignant tumor; * Unstable hemodynamic response or SaO status, such as systolic pressure \<50 mm Hg (1mmHg=0.133 kPa) , or arterial SaO\<80%. * Liver Biochemistry: alanine aminotransferase (ALT)\>6ULN, total bilirubin (TBil)\>50umol/L; * Graft liver has a steatosis \>30%, or graft kidney has a proximal tubular necrosis\>50% or obvious glomerular sclerosis.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change From Baseline in Aspartate Aminotransferase(AST)/Alanine Aminotransferase(ALT) | up to 6 months |
| Change From Baseline in direct bilirubin(DBil)/total bilirubin(TBil) | up to 6 months |
| Change From Baseline in creatinine | up to 6 months |
| Change From Baseline in glomerular filtration rate（GFR） | up to 6 months |
Secondary
| Measure | Time frame |
|---|---|
| Early graft function incidence | baseline and 6 months |
| Pathological score of liver/kidney preservation injury during surgery | during surgery |
| Recipient survival | baseline and 6 months |
| Graft dysfunction incidence | baseline and 6 months |
| Mitochondrial function index of hepatocyte/nephrocyte during surgery | during surgery |
| The total incidence of adverse events/incidence of severe adverse events | up to 6 months |
| postoperative complications | up to 6 months |
Countries
China
Contacts
Primary ContactXia Qiang, investigator
Backup ContactXue Feng, investigator
Outcome results
None listed