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Association of Intraoperative Renal Regional Oxygen Saturation and Acute Kidney Injury

Not Applicable
Completed
Conditions
Liver Transplant; Complications
Renal Injury
Interventions
Device: Near-infrared spectroscopy
Registration Number
NCT03877133
Lead Sponsor
Seoul National University Hospital
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Adult patients scheduled to undergo elective living donor liver transplantation
  • Patients who provided written informed consent
Exclusion Criteria
  • Missing preoperative serum creatinine value
  • Underlying kidney disease, such as hepatorenal syndrome, chronic kidney disease
  • History of unilateral or bilateral nephrectomy
  • Patients who died within 48 hours immediately after surgery
  • Any skin problem at the attachment site of regional oxygen saturation probe

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Regional oxygen saturation groupNear-infrared spectroscopyNear-infrared spectroscopy application to the skin near the kidney
Primary Outcome Measures
NameTimeMethod
Acute Kidney InjuryWithin 7 days after surgery

Acute kidney injury defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria using postoperative serum creatinine

Secondary Outcome Measures
NameTimeMethod
Nadir oxygen delivery during the surgeryWithin average 8 hours after anesthesia induction during the transplantation surgery

Nadir oxygen delivery calculated by the cardiac output and arterial oxygen content

Early allograft dysfunctionon the postoperative 7th day after liver transplantation

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.

Length of hospital stayWithin 30 days after surgery

Length of hospital stay

Area under the curve of oxygen delivery during the surgeryWithin average 8 hours after anesthesia induction during the transplantation surgery

Area under the curve of oxygen delivery calculated by the cardiac output and arterial oxygen content

In-hospital mortalityWithin 30 days after surgery

In-hospital mortality

Trial Locations

Locations (1)

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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