Remote ischemic conditioning on recipients of deceased renal transplants does not improve early graft function: A multicentre randomised, controlled clinical trial.
Krogstrup NV, Oltean M, et al.American Journal of Transplantation 2016 [record in progress].
Aims
This study aimed to investigate whether recipient remote ischemic conditioning (RIC) before kidney graft reperfusion reduces the time to graft recovery in deceased donor renal transplantation.
Interventions
Participants were randomised to either the RIC intervention or sham-RIC.
Participants
Adult patients with end stage renal disease receiving a renal transplant from a brain death donor (DBD) or circulatory death donor (DCD).
Outcomes
The primary outcome was the estimated time to a 50% decrease in plasma creatinine(P-cr). Additional outcomes included need for dialysis after transplanatation, primary non function (PNF), measured glomerular filtration rate (GFR) at day 5, estimated glomerular filtration rate (eGFR) at day 21 post-transplant, plasma neutrophil gelatinase-associated lipocalin P-NGAL from baseline to day 3, and the length of hospital stay.
Follow-up
Not reported
CET Conclusions
This study investigated the role of remote ischaemic preconditioning (using a thigh tourniquet) prior to reperfusion in deceased-donor renal transplantation. The multicentre study recruited 225 recipients, and found no evidence of benefit with equivalent serum creatinine fall, DGF and PNF rates and graft function with treatment or sham. The well-designed study was double-blinded, and although a per-protocol analysis was performed it is unlikely to have affected the findings as the number of drop-outs was small. It remains to be seen if there is a subgroup of patients in whom ischaemic preconditioning may be of benefit, although no trends in any subgroups were seen in the present study.
Data analysis
Per protocol analysis
Trial registration
ClinicalTrials.gov - NCT01395719