Remote Organ Ischemic Preconditioning
Conditions
Keywords
Remote organ ischemic preconditioning, Ischemia reperfusion injury, Glycocalyx integrity parameters, Systemic inflammation parameters
Brief summary
Ischemia-reperfusion (IR) injury during liver transplantation is one of the major causes of mortality and morbidity associated with transplantation. Remote organ ischemic preconditioning (RIPC) is one of the most investigated practices to reduce IR injury. In this study, for the first time in the clinic, the effect of RIPC will be evaluated via both systemic inflammation parameters and also parameters showing glycocalyx integrity, on living-donor liver recipients.
Interventions
PROCEDURERemote ischemic preconditioning
An orthopedic tourniquet was tied to the right lower extremities of the patients in RIPC arm, and tourniquet application was performed before the anhepatic phase in 3 periods of 3 minutes with an interval of 3 minutes.
Sponsors
Acibadem University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients followed up by Acıbadem Hospital Organ Transplantation Center * Patients accepted to participate in the study * Older than 18 years of age * ASA class III * MELD score \>12 * Scheduled for elective liver transplantation surgery from a living donor
Exclusion criteria
* Patients undergoing re-transplantation * Under the age of 18 years * Patients undergoing emergency surgery * Patients with hepatorenal or hepatopulmonary syndrome * Patients receiving mechanical ventilation support in the ICU * Patients refusing to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| soluble Vascular cell adhesion molecule-1 (sVCAM-1). | Postoperative early period (6 hours after intensive care unite admission) | Evaluation of sVCAM-1 level difference between groups |
| Intercellular adhesion molecule-1 (ICAM-1) | Postoperative early period (6 hours after intensive care unite admission) | Evaluation of (ICAM-1) level difference between group |
| Hypoxia-induced factor-1 (HIF-1) | Postoperative early period (6 hours after intensive care unite admission) | Evaluation of HIF-1 level difference between groups |
| Interleukin-8 (IL-8) | Postoperative early period (6 hours after intensive care unite admission) | Evaluation of IL-8 level difference between groups |
| Syndecan-1 (SDC-1) | Postoperative early period (6 hours after intensive care unite admission) | Evaluation of SDC-1 level difference between groups |
| Tumor necrosis factor-alpha (TNF-alpha) | Postoperative early period (6 hours after intensive care unite admission) | Evaluation of TNF-alpha level difference between groups |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Liver function tests | 7 days after surgery | Evaluation of early postoperative liver function tests; AST and ALT |
| Length of stay in hospital and intensive care unit | 7 days after surgery | Evaluation of the length of stay in hospital and intensive care unit |
| Morbidity | 7 days after surgery | Early postoperative complications |
| Mortality | 7 days after surgery | Early postoperative mortality |
Countries
Turkey (Türkiye)
Outcome results
None listed