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.
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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
50
Regional oxygen saturation probe is applied to the skin near the kidney bilaterally and is connected to the regional oxygen saturation monitor.
Seoul National University Hospital
Seoul, South Korea
Acute Kidney Injury
Acute kidney injury defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria using postoperative serum creatinine
Time frame: Within 7 days after surgery
Length of hospital stay
Length of hospital stay
Time frame: Within 30 days after surgery
Nadir oxygen delivery during the surgery
Nadir oxygen delivery calculated by the cardiac output and arterial oxygen content
Time frame: Within average 8 hours after anesthesia induction during the transplantation surgery
Area under the curve of oxygen delivery during the surgery
Area under the curve of oxygen delivery calculated by the cardiac output and arterial oxygen content
Time frame: Within average 8 hours after anesthesia induction during the transplantation surgery
Early allograft dysfunction
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.
Time frame: on the postoperative 7th day after liver transplantation
In-hospital mortality
In-hospital mortality
Time frame: Within 30 days after surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.