Pre and post surgery Ultrasound Doppler derived Renal Resistive index to predict kidney injury after liver transplant surgery.

Completed

Conditions: Biliary cirrhosis, unspecified, (2) ICD-10 Condition: K740||Hepatic fibrosis, (3) ICD-10 Condition: K746||Other and unspecified cirrhosis ofliver, (4) ICD-10 Condition: K743||Primary biliary cirrhosis, (5) ICD-10 Condition: K744||Secondary biliary cirrhosis,

Registration Number: CTRI/2022/07/044056

Lead Sponsor: Institue of Liver and Biliary Sciences ILBS

Brief Summary: Livertransplant surgery is commonly associated with post-operative acute kidneyinjury (AKI), leading to prolonged Intensive Care Unit/Hospital stay andsignificant morbidity. The causes of postoperative acute kidney injury (AKI) aremultifactorial, including hepatic decompensation of recipients, diabetes mellitus,poor donor graft quality, intraoperative hemodynamic instability, blood lossand blood product transfusions, and nephrotoxic drug administration. Earlydiagnosis of AKI leading to implementation of reno-protective strategies cansignificantly improve clinical outcomes in LT recipients. Oneof the cardinal features of AKI is intrarenal vasoconstriction, which leads torenal hypoperfusion and subsequent manifestations of AKI, including oliguriaand elevated serum creatinine. Authors have previously shown a definitive rolefor ultrasound dopplerâ€“derived renal artery resistive index, also called renalresistive index (RRI), in predicting AKI following major cardiac and orthopedicprocedures. We seek to investigate the role of RRI in identifying patientsdeveloping post-LT AKI. We postulate that regular monitoring of RRI in our LTrecipients would help us identify these patients.

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 70

Inclusion Criteria

Patients of age 18 to 65 years who will be undergoing Living Donor Liver Transplantation in Institute of Liver and Biliary sciences during the study period.

Exclusion Criteria

patient refusal, acute liver failure patients undergoing liver transplant, patients with pre-op Hepatorenal syndrome or Acute Kidney Injury in last 7 days or chronic renal failure, patients with renal artery stenosis, refractory ascites, patients undergoing redo-LDLT for graft failure and patients with poor echogenicity.
inability to view kidney by ultrasound.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To determine whether preoperative and elevated postoperative Renal Resistive Index (RRI) predicts the post liver transplant Acute Kidney Injury	Renal Resistive Index will be done on the day before surgery and on post-operative day 1 and 2. patient will be followed up upto 14 days for any development of AKI.

Secondary Outcome Measures

Name	Time	Method
To study the effect of MELD Na score, duration of surgery, duration of warm and cold ischaemia time, blood loss and transfusion, amaount and type of fluid replacement, duration of IVC cross clamp, post reperfusion syndrome on the incidence of AKI.	To find the incidence of AKI following liver transplant.

Trial Locations

Locations (1): Institute of Liver and Biliary Sciences ILBS
🇮🇳
South, DELHI, India
Institute of Liver and Biliary Sciences ILBS
🇮🇳South, DELHI, India
DR SARAVANAN M
Principal investigator
9789560136
dr.saravanan92@gmail.com