Risk of Acute Kidney Injury in Living Liver Donor Surgery

Completed

• Conditions: Fluid and Electrolyte Imbalance; Acute Kidney Injury; Liver Transplant; Complications

• Registration Number: NCT05255510
• Lead Sponsor: Ankara University

Brief Summary

Acute kidney injury (AKI) is one of the most common complication after restricted fluid therapy for major surgery. The aim of this study is to evaluate the incidence of AKI as defined by Kidney Disease Improving Global Outcomes (KDIGO) criteria in living liver donor hepatectomy in which applied intraoperative protocolized fluid restriction targeting a low central venous pressure (CVP) level and high pulse pressure variation (PPV) / systolic pressure variation (SPV).

Detailed Description

Operative blood loss and need for transfusion are risk factors associated with mortality after partial hepatectomy. The low central venous pressure (CVP) anesthetic technique has been strongly advocated to minimize hepatic venous bleeding during hepatectomy. Low CVP technique for living donor hepatectomy may not be advantageous regarding the safety of healthy living donors. Safer, simpler, and more useful fluid management methods are, therefore, required to reduce blood loss and subsequent morbidity during living donor hepatectomy. Pulse pressure variation (PPV) and systolic pressure variation (SPV) are the dynamic parameters of hemodynamic used to access the volume status and fluid responsiveness in mechanically ventilated patients.

Based only on the serum creatinine increase, AKI occurs in 5-15% of hepatectomy patients.In this study, we aimed to evaluate the incidence of AKI based on the change of serum creatinine levels in living liver donor hepatectomy regarding intraoperative fluid restriction targeting low CVP levels and high PPV and SPV depending on our protocolized fluid management.

130 living liver donors were admitted for a retrospective observational study. The low central venous pressure (\<5 mmHg) and high pulse pressure variation (PPV\<20%) / systolic pressure variation (SPV\<15%) were applied to reduce intraoperative blood loss as fluid management until the end of the hepatic parenchymal division. AKI was defined using the KDIGO criteria according to the serum creatinine. The SPSS 11.5 program was used for statistical analysis.

Study Timeline

• Study Start: 2019-10-10
• Primary Completion: 2020-06-01
• Study Completion: 2021-06-10
• Study First Submitted: 2022-02-14
• Study First Submitted QC: 2022-02-15
• Study First Posted: 2022-02-24
• Status Verified: 2022-05
• Last Update Submitted: 2022-05-09
• Last Update Posted: 2022-05-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 130

Inclusion Criteria

• patients who underwent living liver donor hepatectomy

Exclusion Criteria

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Acute kidney injury in living donor patients	one week	Kidney Disease Improving Global Outcomes (KDIGO) criteria

Trial Locations

Locations (1)

Süheyla Karadağ Erkoç; 🇹🇷 Ankara, Turkey