niertransplantatie living donor kidney transplantation
Conditions
Interventions
None listed
Sponsors
Universitair Medisch Centrum Groningen
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: donor/recipient couples requiring general anaesthesia for a living donor kidney donation/transplantation age > 18 years
Exclusion criteria
Exclusion criteria: patient refusal BMI35 neurological disorder recent use of psycho-active medication, including alcohol Donor-recipient couples from the ABO-incompatible program Altruistic donor
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary outcome measures: Signs of renal injury reflected by kidney injury biomarkers in transplanted kidney*s urine. We will use a set of biomarkers consisting of: 1) KIM-1: Kidney Injury Molecule-1: a scavenger receptor on renal epithelial cells which converts the normal proximal tubule cell into a phagocyte. KIM-1 expression is not measurable in normal proximal tubule cells and is markedly upregulated with injury/dedifferentiation. It is highly expressed on the apical domain of the cell and its large ectodomain is cleaved and is stable as it is excreted in the urine. Its presence in the urine is highly specific for kidney injury. No other organs have been shown to express KIM-1 2) NAG: N-acetyl-glucosaminidase: lysosomal enzyme in proximal tubular epithelial cells, released during renal injury 3) H-FABP: Heart-fatty-acid-binding-protein. Marker for distal tubular injury. | — |
Secondary
| Measure | Time frame |
|---|---|
| -kidney biopsy specimen analysis -assays of inflammatory markers: TNF-a, IL-1β, IL-6, IL-8, TGF-β, iNOS, MCP-1, TLR4, C3, C5AR -NF-*B translocation, MAP-kinases -protective heat shock proteins like HO-1, HSP70 -leucocyte infiltration, complement activation -endothelial adhesion molecules VCAM-1, ICAM-1, E-selectin, vWF, C3, C5AR -expression of angiopoietine 1 en 2 -caspase 3 -BCL-2/BAX ratio -plasma creatinine levels -proportional change in plasma creatinine level (% compared to pre transplantation) -GFR and creatinine clearance -need for postoperative diuretics -delayed graft function (need for dialysis | — |
Countries
Netherlands
Outcome results
None listed