Remote ischemic conditioning enhanced the early recovery of renal function in recipients after kidney transplantation: a randomized controlled trial

Wu, Jiang; Feng, Xiaoxiao; Huang, Hongfeng; Shou, Zhangfei; Zhang, Xiaohui; Wang, Rending; Chen, Yanyan; Chen, Jianghua

doi:10.1016/j.jss.2013.06.058

Cited by 53 publications

(48 citation statements)

References 29 publications

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“…RIPC of renal transplant recipients has been investigated in 2 recent trials including both living 19 and deceased 20 The aims of this study was to perform a prospective randomized controlled feasibility study to address these issues and to obtain preliminary data on which to design a further prospective trial to determine efficacy and cost effectiveness. Patients above the age of 18 undergoing first elective deceased donor liver transplantation were enrolled with informed consent in the study for randomization.…”

Section: Discussionmentioning

confidence: 99%

Remote ischaemic preconditioning in orthotopic liver transplantation (RIPCOLT trial): a pilot randomized controlled feasibility study

Robertson

Goswami

Wright

et al. 2017

HPB

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Abstract:Ischaemia Reperfusion (IR) injury is a major cause of post-operative morbidity, mortality and graft loss following Orthotopic Liver Trasnplantation (OLT). There is no current accepted treatment for IR injury. The recent drive to implant more marginal grafts, which are more susceptible to IR injury makes this clinical problem a key research goal. Remote Ischaemic Preconditioning (RIPC) has been shown to ameliorate hepatic IR injury in small animal models. Whether recipient RIPC can reduce IR injury in human liver transplant recipients has not previously been investigated. Methods:Forty patients with end stage liver disease undergoing liver transplantation were randomized to RIPC or a sham control group. RIPC was induced through three 5 minute cycles of alternate ischaemia and reperfusion using an orthopaedic tourniquet to the left lower limb under general anaesthesia prior to commencement of the abdominal procedure. The aim of the study was to determine the safety and feasibility of limb RIPC in patients with end stage cirrhosis. Data on clinical outcomes was collected prospectively (minimum 3 month follow up) and the function of the graft was also evaluated. Plasma cytokine levels were measured at baseline, 2 hours post reperfusion and at 24 hours post-operatively. Results:45 of 51 patients approached (88%) were willing to enroll in the study. 5 patients were then excluded and 40 patients were randomized of which 20 underwent RIPC.RIPC was able to be performed in all patients randomized to the RIPC group. There was no evidence of localized complications following RIPC. One patient died in the control group and 1 further graft was lost in the control group due to a non-IR related 3 issue. Median AST levels on the third post-operative day showed a slightly higher trend in the RIPC group than in the control group (221iU vs 149iU, p=1.00) but this was not statistically significant. Conclusions:RIPC is acceptable and can be carried out safely in patients with advanced liver disease. This pilot feasibility study has not demonstrated evidence of a reduction in IR injury or clinical benefit. A longer follow up, a larger study or an altered preconditioning protocol may be required. 4Liver transplantation is the treatment of choice for both acute and chronic end stage liver disease. As outcomes following transplantation have improved, the indications for liver transplantation have been widened and a shortage of suitable organ donors has developed. This has resulted in an increased use of grafts from marginal donors such as the elderly and those with a fatty liver from obesity (extended criteria donors) and especially the use of grafts from donors following cardiac death (DCD). The use of liver DCD grafts in the UK has increased from 6.9% in 2005 1 to 19.1% of grafts implanted in 2013 2 .Ischaemia Reperfusion (IR) injury is the damage that happens to an organ when its blood supply is interrupted and reconstituted. It is a major cause of morbidity and mortality following liver transplantation and is believed to acc...

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Section: Discussionmentioning

confidence: 99%

Remote ischaemic preconditioning in orthotopic liver transplantation (RIPCOLT trial): a pilot randomized controlled feasibility study

Robertson

Goswami

Wright

et al. 2017

HPB

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“…1) Early RIPC -no effect on iohexol GFR at 1 year, ↑ eGFR at 3 and 12 months Late RIPC -no effect RIPerC Wu [43] …”

Section: 허혈 조건화의 분류mentioning

confidence: 99%

Kidney transplantation and ischemic conditioning: past, present and future perspectives

Jung

2018

Anesth Pain Med

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“…Оно не повлияло на смерть пересаженной почки через 1 и 3 года после трансплантации, длительность пребывания в стационаре, клубочковую фильтрацию [31]. Несколько иные данные получи-ли китайские трансплантологии [32]. В этом исследовании ДИП воспроизводили не у доноров, а у реципиентов, с этой целью осу-ществляли 3 цикла ишемии (5 мин) и реперфузии (5 мин) под-вздошной артерии перед трансплантацией почки.…”

Section: контактная информацияunclassified

“…В качестве маркера ишемического и реперфузионного повреждения почек использовали нейтро-фильный желатиназо-ассоциированный липокалин (NGAL, neutrophil gelatinase-associated lipocalin), который определяли в моче реципиентов. Оказалось, что ДИП способствует снижению уровня этого маркера по сравнению с показателями в группе кон-троля (трансплантация без ДИП) [32]. Следовательно, ДИП сни-жает выраженность ишемического и реперфузионного повреж-дения почки при трансплантации.…”

Section: контактная информацияunclassified

Neuroprotective and nephroprotective effects of remote postconditioning: Prospects for clinical use

Maslov

Tsibulnikov

Цепокина

et al. 2016

Terapevticheskii arkhiv

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1 фГБну «нИИ кардиологии», Томск, россия; 2 национальный исследовательский Томский политехнический университет, Томск, россия; 3 фГБну нИИ комплексных проблем сердечно-сосудистых заболеваний, Кемерово, россия; 4 республиканский научно-прак-тический центр «Кардиология», Минск, Беларусь Аннотация результаты экспериментальных и клинических исследований убедительно свидетельствуют, что дистантное ишемическое прекондиционирование (ДИП) не оказывает нейропротекторного эффекта при кардиохирургических вмешательствах, выполняемых в условиях искусственного кровообращения. Дистантное прекондиционирование (ДК) не оказывает нейро-протекторного эффекта при геморрагическом инсульте. необходимо проведение рандомизированного многоцентрового исследования для оценки эффективности ДИП у пациентов с ишемическим инсультом. ДК снижает выраженность ишеми-ческого и реперфузионного повреждения почки при трансплантации. установлено, что ДИП предупреждает появление нефропатии, индуцированной контрастным веществом. необходимо многоцентровое исследование для оценки эффек-тивности ДИП у пациентов с протезированием аневризмы брюшной аорты. Анализ представленных данных свидетель-ствует, что ДИП не предупреждает возникновение кардиоренального синдрома у новорожденных и детей при выполнении кардиохирургических вмешательств. Данные литературы о способности ДИП оказывать нефропротекторный эффект у пациентов с коронарным шунтированием носят противоречивый характер и свидетельствуют о целесообразности про-ведения многоцентрового исследования. The results of experimental and clinical studies strongly suggest that remote ischemic preconditioning (rIP) has no neuroprotective effect during cardiac surgery performed under extracorporeal circulation. remote preconditioning (rP) has no neuroprotective effect in hemorrhagic stroke. A randomized multicenter study is needed to evaluate the efficiency rIP in patients with ischemic stroke. rP reduces the severity of ischemia/reperfusion kidney injury during transplantation. rIP has been established to prevent contrast-induced nephropathy. There is a need for a multicenter trial to evaluate the efficiency of rIP in patients with abdominal aortic aneurysm repair. Analysis of the presented data indicates that rIP fails to prevent cardiorenal syndrome in infants and children during cardiac surgery. The data available in the literature on the capacity of rIP to provide nephroprotective effect in patients after coronary artery bypass surgery are discordant and indicative of the advisability of a multicenter study. Keywords: remote ischemic preconditioning, brain, kidneys.Дистантное ишемическое прекондиционирование (ДИП) -это феномен повышения устойчивости к длительной ишемии и реперфузии одного органа после кратковременной ишемии-ре-перфузии другого органа. Полагают, что кратковременная ише-мия и реперфузия вызывают выброс в кровоток гуморального фактора(ов), которые повышают толерантность органов и тканей к ишемии и реперфузии [1][2][3][4][5][6][7]. Предполагают, что подобными факторами могут быть эндогенные каннабин...

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Remote ischemic conditioning enhanced the early recovery of renal function in recipients after kidney transplantation: a randomized controlled trial

Cited by 53 publications

References 29 publications

Remote ischaemic preconditioning in orthotopic liver transplantation (RIPCOLT trial): a pilot randomized controlled feasibility study

Remote ischaemic preconditioning in orthotopic liver transplantation (RIPCOLT trial): a pilot randomized controlled feasibility study

Kidney transplantation and ischemic conditioning: past, present and future perspectives

Neuroprotective and nephroprotective effects of remote postconditioning: Prospects for clinical use

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