Abstract: SA-PO815
Efficacy of Remote Ischemic Preconditioning in Living Donor Renal Transplantation: A Randomized Controlled Trial
Session Information
- Transplantation: Clinical - Pretransplant Assessment and Living Donors
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Gupta, Anurag, Sir Ganga Ram Hospital, New Delhi, Delhi, India
- Pawar, Nikita, Sir Ganga Ram Hospital, New Delhi, Delhi, India
- Tiwari, Vaibhav, Sir Ganga Ram Hospital, New Delhi, Delhi, India
- Bhargava, Vinant, Sir Ganga Ram Hospital, New Delhi, Delhi, India
- Malik, Manish, Sir Ganga Ram Hospital, New Delhi, Delhi, India
- Bhalla, Anil, Sir Ganga Ram Hospital, New Delhi, Delhi, India
- Gupta, Ashwani, Sir Ganga Ram Hospital, New Delhi, Delhi, India
- Rana, Devinder S., Sir Ganga Ram Hospital, New Delhi, Delhi, India
Background
In kidney transplantation, ischemia-reperfusion injury (IRI) is an inevitable complication. However, paradoxically, an additional injury occurs upon reperfusion which limits the amount of tissue that can be salvaged. This is termed ‘ischemia-reperfusion injury’ (IRI). Different strategies have been tried to reduce ischemic reperfusion injuries. Ischemic preconditioning is one of such strategies. Thus, we have conducted RIPC, a randomized controlled trial in patients undergoing renal transplantation.
Methods
A randomized controlled trial was done to assess the efficacy and safety of remote ischemic preconditioning in living donor renal transplantation from June 2020 to September 2021. This study was conducted on a total of 110 ABO compatible live donor kidney transplant recipients. Randomization was done, 58 patients in the RIPC group and 52 patients in the control group were studied. They were followed for 3 months of study.
primary objective- the proportion of patients achieving a 50% decline in serum creatinine level at 72 hours after transplantation and oliguria on day 1, 2 and 3.
secondary objective-eGFR at 3 months of transplantation, acute rejections, and delayed graft function.
Results
The mean age in both groups was comparable (37.09 vs 38.3 years) All patients showed a >50% decline in creatinine level at 72 hours of transplant. The mean serum creatinine on day 7 of transplant level in the RIPC group was 1 mg/dL and 1.1 mg/dL in the control group. There was no oliguria in 1st 3 days. There was no difference in urine output in both groups. The stable graft function was present in 83.6% of cases. It was higher in the RIPC group compared to the control group (p=0.08). Delayed graft function was present in 3.8% of cases in the control group and 1.7% in the RIPC group (p=0.9). Similarly, slow graft function was present in 17.3% in the control group while 10.3% in the RIPC group (p=0.8). The mean serum creatinine level in both groups was the same at 3 months, 1.2 mg/dL. Acute tubular necrosis was the most common finding on biopsy (63.6%). Acute rejections were similar in both the groups (2 vs 3; p=0.9)
Conclusion
There was no effect of RIPC on slow graft function, rate of fall of creatinine, graft function and rate of rejection at 3 months.