The purpose of this study is to investigate whether upper limb ischemic postconditioning can improve renal function and decrease ischemic-reperfusion injury in patients undergoing living donor kidney transplantation.
Ischemic reperfusion injury after kidney transplantation is a common clinical problem associated with a high morbidity and mortality. To reduce the adverse effect of ischemic reperfusion injury after organ transplantation, various strategies including ischemic preconditioning or postconditioning. Remote ischemic postconditioning is one of such strategies where brief ischemic reperfusion injury of one organ protects other organs from sustained ischemic reperfusion injury. Remote ischemic postconditioning of the limb with a tourniquet is a safe and convenient method of postconditioning organs against ischemic reperfusion injury. However, the efficacy of remote ischemic postconditioning in patients undergoing living donor kidney transplantation needs to be established. Therefore, we investigate the efficacy of remote ischemic postconditioning of the upper limb with a tourniquet in recipients of kidney transplantation by measuring the markers of acute kidney injury.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
60
Remote ischemic postconditioning consists of three 5-min cycles of upper limb ischemia, which was induced by an automated cuff-inflator placed on the upper limb free of arteriovenous fistula and inflated to 250 mm Hg, with an intervening 5 min of reperfusion during which the cuff was deflated.
Samsung Seoul Hospital, Samsung Medical Center
Seoul, South Korea
renal function of recipient after living-related kidney transplantation
serum creatinine concentration and urine output
Time frame: 1 day before surgery
renal function of recipient after living-related kidney transplantation
serum creatinine concentration and urine output
Time frame: at 2 h after declaming of renal artery
renal function of recipient after living-related kidney transplantation
serum creatinine concentration and urine output
Time frame: at 6 h after declaming of renal artery
renal function of recipient after living-related kidney transplantation
serum creatinine concentration and urine output
Time frame: at 12 h after declaming of renal artery
renal function of recipient after living-related kidney transplantation
serum creatinine concentration and urine output
Time frame: at 24 h after declaming of renal artery
renal function of recipient after living-related kidney transplantation
serum creatinine concentration and urine output
Time frame: at 48 h after declaming of renal artery
renal function of recipient after living-related kidney transplantation
serum creatinine concentration and urine output
Time frame: at 72 h after declaming of renal artery
Biomarkers of acute kidney injury
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biomarkers of acute kidney injury: Plasma cystatin-C, Urine IL-18, Urine Neutrophil gelatinase-associated lipocalin (NGAL)
Time frame: before surgery and at 2, 6, 12 h after declaming of renal artery
Hemodynamic parameters
arterial blood pressure, heart rate, central venous pressure, pulse oximetry
Time frame: before surgery and at 2, 6, 12, 24, 48, 72 h after declaming of renal artery
outcome of kidney transplantation
number of acute rejection or number of delayed graft function
Time frame: at 72 h after declaming of renal artery
postoperative hospital stay
length of postoperative hospital stay (days)
Time frame: at postoperative day 60