Clinical trial NCT02559297: Effects of Sevoflurane and Desflurane on Treg
Official title: Effects of Sevoflurane and Desflurane Anesthesia on Regulatory T Cells in Patients Undergoing Living Donor Kidney Transplantation
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Transplant; Failure, Kidney
Keywords: Regulatory T cells
Sevoflurane
Desflurane
Cytokines
Flow cytometry
Living Donor Kidney Transplant
Lead sponsor: Mahidol University
Sponsor class: OTHER
First posted: 2015-09-24
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This prospective interventional study aims to compare sevoflurane and desflurane anesthetic agents on regulatory T cell (Treg) numbers and its cytokine production in patients undergoing Living Donor Kidney Transplant (LDKT).

Detailed description: All patients with end stage renal disease (ESRD) need renal replacement therapy, either dialysis or kidney transplantation. Dialysis, despite its effectiveness in prolonging ESRD patients' lives, is a burden. Successfulness in kidney transplantation will restore good quality of life in ESRD patients. However, one of the most important complications that lead to transplant failure is graft rejection. It is already known that the pathophysiology of the rejection is immune response. Recent evidence showed that regulatory T cell (Treg) plays a central role in preventing graft rejection by inhibiting recipient alloimmune response (1-3). Characterization of Treg numbers and/or functional changes under various conditions may lead to a new preventive measure and/or a novel therapeutic strategy for graft rejection.

Kidney transplantation is conducted under general anesthesia. Interestingly, several agents used in general anesthesia have also modulated immune functions (4-12). Although the effect of inhalation anesthetic agents on leukocyte count has been shown, the effect on Treg function has totally been unknown. Knowing the effects of inhalation agents on Treg numbers and functions will be beneficial to intraoperative management during transplant surgery, aiming toward reducing the risk of graft rejection in the future.

Eligibility criteria: Inclusion Criteria:

* Patients receiving 1st living donor kidney transplantation

Exclusion Criteria:

* Hyperacute graft rejection
* Pre-existing autoimmune or immunodeficiency diseases in recipients
* Receiving blood product during 24-h perioperative period
* Patient refuse to participate this study at any time point

Primary outcomes:
measure: Number of regulatory T cells
timeFrame: Within 24-h peri-operative period
Secondary outcomes:
measure: T lymphocyte cytokine production
timeFrame: Within 24-h peri-operative period
Other outcomes:
Locations:
city: Ratchathewi
country: Thailand
facility: Ramathibodi Hospital
state: Bangkok
Study officials:
affiliation: Department of Anesthesia, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
name: Arpa Chutipongtanate, MD
role: PRINCIPAL_INVESTIGATOR
References:
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