Impact of Dexmedetomidine on Acute Kidney Injury Following Living Donor Liver Transplantation

Study Overview
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Brief Summary
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Acute kidney injury (AKI) following liver transplantation (LT) is associated with increased costs, morbidity, and mortality. Dexmedetomidine has known to have anti-inflammatory effect and has been shown to ameliorate IRI in several organs. However, the impact of Dexmedetomidine on AKI after LT is not determined yet. Therefore, this study aims to observe the renal protective effects of Dexmedetomidine after LT.

Detailed Description
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Acute kidney injury (AKI) following liver transplantation (LT) has shown a wide range of incidence between 17% and 95% and is associated with increased costs, morbidity, and mortality. The etiology of AKI after LT is multifactorial. Among these factors, renal ischemia-reperfusion injury (IRI) caused by perioperative renal hypoperfusion is considered as one of the most important independent risk factors and recent reports have indicated that IRI is associated with an inflammatory cascade. Dexmedetomidine which is a highly selective agonist of α2-adrenergic receptors has known have anti-inflammatory effect and has been shown to ameliorate IRI in several organs. However, the impact of Dexmedetomidine on AKI after LT is not determined yet. Therefore, this study aims to observe the renal protective effects of Dexmedetomidine after LT.

Official Title
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Impact of Dexmedetomidine on Acute Kidney Injury Following Living Donor Liver Transplantation: A Randomized Controlled Study

Conditions
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Acute Kidney Injury, Liver Diseases

Intervention / Treatment
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* Drug: Dexmedetomidine
* Drug: Normal saline


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: living liver transplantation recipients Exclusion Criteria: preoperative renal dysfunction dual living donor liver transplantation severe cerebral artery disease severe cardio-pulmonary disease

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: control group<br>The control group was given normal saline by constant intravenous (IV) infusion at a rate of 0.4mcg/kg/hour | Drug: Normal saline<br>* The control group was given normal saline by constant intravenous (IV) infusion at a rate of 0.4mcg/kg/hour<br>|
| Active Comparator: treatment group<br>The treatment group was given dexmedetomidine by constant intravenous (IV) infusion at a rate of 0.4mcg/kg/hour | Drug: Dexmedetomidine<br>* The treatment group was given dexmedetomidine by constant intravenous (IV) infusion at a rate of 0.4mcg/kg/hour.<br>* Other names: precedex;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| acute kidney injury | serum creatinine levels in postoperative 7 days | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| lactate level | serial lactate level during operation and postoperative 3 days | 3 days | 
| delirium | The incidence of delirium | postoperative day 7 | 
| early allograft dysfunction | early allograft dysfunction | postoperative day 7 | 
| duration of mechanical ventilation | duration of mechanical ventilation (hours) | up to 1 year | 
| intensive care unit length of stay | intensive care unit length of stay (days) | up to 1 year | 
| hospital length of stay | hospital length of stay (days) | up to 1 year | 
| graft failure | recipient death or re-transplantation within 1 year | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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acute kidney injury, liver transplantation, dexmedetomidine