The Effects Of Remote Organ Ischemic Preconditioning On Systemic Inflammatory And Glycocalyx Integrity Parameters

Study Overview
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Brief Summary
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Ischemia-reperfusion (IR) injury during liver transplantation is one of the major causes of mortality and morbidity associated with transplantation. Remote organ ischemic preconditioning (RIPC) is one of the most investigated practices to reduce IR injury. In this study, for the first time in the clinic, the effect of RIPC will be evaluated via both systemic inflammation parameters and also parameters showing glycocalyx integrity, on living-donor liver recipients.

Official Title
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The Effects Of Remote Organ Ischemic Preconditioning On Systemic Inflammatory And Glycocalyx Integrity Parameters In Living-Donor Liver Transplantation Patients

Conditions
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Remote Organ Ischemic Preconditioning

Intervention / Treatment
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* Procedure: Remote ischemic preconditioning


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients followed up by Acıbadem Hospital Organ Transplantation Center Patients accepted to participate in the study Older than 18 years of age ASA class III MELD score >12 Scheduled for elective liver transplantation surgery from a living donor Exclusion Criteria: Patients undergoing re-transplantation Under the age of 18 years Patients undergoing emergency surgery Patients with hepatorenal or hepatopulmonary syndrome Patients receiving mechanical ventilation support in the ICU Patients refusing to participate

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Remote Ischemic Preconditioning<br>Short-term tourniquet on to the lower extremity before surgery | Procedure: Remote ischemic preconditioning<br>* An orthopedic tourniquet was tied to the right lower extremities of the patients in RIPC arm, and tourniquet application was performed before the anhepatic phase in 3 periods of 3 minutes with an interval of 3 minutes.<br>|
| No Intervention: Control<br>No intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tumor necrosis factor-alpha (TNF-alpha) | Evaluation of TNF-alpha level difference between groups | Postoperative early period (6 hours after intensive care unite admission) | 
| Intercellular adhesion molecule-1 (ICAM-1) | Evaluation of (ICAM-1) level difference between group | Postoperative early period (6 hours after intensive care unite admission) | 
| Hypoxia-induced factor-1 (HIF-1) | Evaluation of HIF-1 level difference between groups | Postoperative early period (6 hours after intensive care unite admission) | 
| Interleukin-8 (IL-8) | Evaluation of IL-8 level difference between groups | Postoperative early period (6 hours after intensive care unite admission) | 
| Syndecan-1 (SDC-1) | Evaluation of SDC-1 level difference between groups | Postoperative early period (6 hours after intensive care unite admission) | 
| soluble Vascular cell adhesion molecule-1 (sVCAM-1). | Evaluation of sVCAM-1 level difference between groups | Postoperative early period (6 hours after intensive care unite admission) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Early postoperative mortality | 7 days after surgery | 
| Liver function tests | Evaluation of early postoperative liver function tests; AST and ALT | 7 days after surgery | 
| Length of stay in hospital and intensive care unit | Evaluation of the length of stay in hospital and intensive care unit | 7 days after surgery | 
| Morbidity | Early postoperative complications | 7 days after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Remote organ ischemic preconditioning, Ischemia reperfusion injury, Glycocalyx integrity parameters, Systemic inflammation parameters