Risk of Acute Kidney Injury in Living Liver Donor Surgery

Acute Kidney Injury Clinical Trial

Official title:

Reducing Risk of Acute Kidney Injury After Living Donor Hepatectomy by Protocolized Fluid Restriction: Single-center Experience

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05255510
• Other study ID #: AnkaraUni
• Status: Completed
• Start date: October 10, 2019
• Est. completion date: June 10, 2021

Study information

• Verified date: May 2022
• Source: Ankara University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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).

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 130
• Est. completion date: June 10, 2021
• Est. primary completion date: June 1, 2020
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• patients who underwent living liver donor hepatectomy

Exclusion Criteria:

-

Related Conditions & MeSH terms

• Acute Kidney Injury
• Fluid and Electrolyte Imbalance
• Liver Transplant; Complications
• Wounds and Injuries

Locations

Country	Name	City	State
Turkey	Süheyla Karadag Erkoç	Ankara

Sponsors (8)

Lead Sponsor	Collaborator
Ankara University	Ali Abbas Yilmaz, Deniz Balci, Elif Beyza Baskan, Elvan Onur Kirimker, Kaan Karayalçin, Mustafa Kemal Bayar, Sevcan Büyük

Country where clinical trial is conducted

Turkey, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Acute kidney injury in living donor patients	Kidney Disease Improving Global Outcomes (KDIGO) criteria	one week