Liver Transplant; Complications, Renal Injury
Conditions
Keywords
Near-infrared spectroscopy, Renal regional oxygen saturation, Living donor liver transplantation, Acute kidney injury
Brief summary
This study is a prospective observational study of a single cohort of the patients who will undergo a scheduled living donor liver transplantation. The investigators attempt to evaluate the association of intraoperative renal regional oxygen saturation and acute kidney injury in patients undergoing living donor liver transplantation. Near-infrared spectroscopy sensor will be attached to the skin near bilateral kidney areas in all patients and renal regional oxygen saturation will be monitored during the operation. Renal regional oxygen saturation (rSO2) of the patients who developed acute kidney injury postoperatively will be compared with rSO2 of the patients who did not.
Detailed description
Acute kidney injury is a frequent complication after liver transplantation, which is related to poor prognosis and longer hospital stay. There is no sensitive or specific marker for predicting postoperative acute kidney injury, although studies of the biomarkers have shown promising results. Near-infrared spectroscopy is a non-invasive and real-time monitoring device for regional oxygen saturation measurement. Previous studies revealed that it could be applied to the skin near the kidney and be used to monitor renal regional oxygen saturation. Therefore, in this study, the investigators will apply near-infrared spectroscopy around kidney area to measure real-time renal regional oxygen saturation during liver transplantation surgery and investigate the association between the intraoperative renal regional oxygen saturation and the development of post-transplant acute kidney injury.
Interventions
DEVICENear-infrared spectroscopy
Regional oxygen saturation probe is applied to the skin near the kidney bilaterally and is connected to the regional oxygen saturation monitor.
Sponsors
Seoul National University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Masking description
Does not need masking
Intervention model description
A prospective, single group, observational study
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients scheduled to undergo elective living donor liver transplantation * Patients who provided written informed consent
Exclusion criteria
* Missing preoperative serum creatinine value * Underlying kidney disease, such as hepatorenal syndrome, chronic kidney disease * History of unilateral or bilateral nephrectomy * Patients who died within 48 hours immediately after surgery * Any skin problem at the attachment site of regional oxygen saturation probe
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acute Kidney Injury | Within 7 days after surgery | Acute kidney injury defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria using postoperative serum creatinine |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of hospital stay | Within 30 days after surgery | Length of hospital stay |
| Nadir oxygen delivery during the surgery | Within average 8 hours after anesthesia induction during the transplantation surgery | Nadir oxygen delivery calculated by the cardiac output and arterial oxygen content |
| Area under the curve of oxygen delivery during the surgery | Within average 8 hours after anesthesia induction during the transplantation surgery | Area under the curve of oxygen delivery calculated by the cardiac output and arterial oxygen content |
| Early allograft dysfunction | on the postoperative 7th day after liver transplantation | Early allograft dysfunction diagnosed by one or more of the following variables: (1) bilirubin \> 10 mg/dL on postoperative day 7; (2) prothrombin time: international normalized ratio \> 1.6 on postoperative day 7; (3) aminotransferase level (alanine aminotransferase or aspartate aminotransferase \> 2000 IU/ml within the first 7 postoperative days. |
| In-hospital mortality | Within 30 days after surgery | In-hospital mortality |
Countries
South Korea
Outcome results
None listed