Remote Ischaemic Preconditioning in Transplantation (RIPTRANS)
Remote Ischaemic Preconditioning in Transplantation (RIPTRANS) - A Prospective Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Ville Sallinen, MD, PhD
- Phone Number: +358-9-4711
- Email: ville.sallinen@helsinki.fi
Study Contact Backup
- Name: Aki Uutela, MD
- Phone Number: +358-9-4711
- Email: aki.uutela@hus.fi
Study Locations
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Helsinki, Finland, 00029
- Recruiting
- Helsinki University Hospital
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Contact:
- Ville Sallinen, MD, PhD
- Phone Number: +358-9-4711
- Email: ville.sallinen@helsinki.fi
-
Contact:
- Aki Uutela, MD
- Phone Number: +358-9-4711
- Email: aki.uutela@hus.fi
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Donor Inclusion Criteria:
- Brain-dead organ donor with a plan of harvesting at least one kidney
Donor Exclusion Criteria:
- Haemodynamically unstable donor
- Age below 18 years
- Planned organ recipients are recruited to another prospective trial, which prevents participation in this trial.
All organ recipients receiving organs (kidney, liver, pancreas-kidney, heart, lungs) from a randomized donor will be recruited providing that the recipient surgery is performed at Helsinki University Hospital, recipient is over 18 years old, and recipient gives written informed consent to participate in the trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: RIPC
RIPC will consist of setting a tourniquet to donor thigh and inflating it to 300mmHg four times 5 minutes with 5 minutes deflating in between each.
RIPC-intervention will be performed twice: First after brain death and second time before procurement procedure.
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Remote Ischaemic Preconditioning
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Sham Comparator: Sham-RIPC
Sham-RIPC will consist of setting a tourniquet to donor thigh without inflating it and keeping it in place for 35 min.
Sham-RIPC-intervention will be performed twice: First after brain death and second time before procurement procedure.
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Sham procedure
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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DGF
Time Frame: 7 days
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Delayed graft function of kidney allografts defined as postoperative dialysis within 1 week from transplantation
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7 days
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Kidney allografts: eGFR
Time Frame: at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Kidney allografts: estimated glomerular filtration rate
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at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Combined Pancreas-Kidney allografts: eGFR
Time Frame: at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Combined Pancreas-Kidney allografts: estimated glomerular filtration rate
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at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Kidney allografts: BPAR
Time Frame: within 1 year
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Kidney allografts: Biopsy proven acute rejection
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within 1 year
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Combined Pancreas-Kidney allografts: Kidney BPAR
Time Frame: within 1 year
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Combined Pancreas-Kidney allografts: Biopsy proven acute rejection in Kidney allograft
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within 1 year
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Kidney allografts: graft survival
Time Frame: at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Kidney allografts: time from transplantation to death, retransplantation or permanent dialysis
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at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Combined Pancreas-Kidney allografts: kidney graft survival
Time Frame: at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Combined Pancreas-Kidney allografts: time from transplantation to death, retransplantation of the kidney or permanent dialysis
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at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Kidney allografts: death-censored graft survival
Time Frame: at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Kidney allografts: time from transplantation to retransplantation or permanent dialysis, death-censored
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at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Combined Pancreas-Kidney allografts: death-censored kidney graft survival
Time Frame: at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Combined Pancreas-Kidney allografts: time from transplantation to retransplantation of the kidney or permanent dialysis, death-censored
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at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Liver allografts: MEAF-score at 3rd POD
Time Frame: 3rd post-operative day
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Liver allografts: Model for Early Allograft Function Scoring (MEAF) (MEAF = (score ALTmax:3POD+ score INRmax:3POD+ score bilirubin3POD), score range 0 - 10, higher score indicates worse outcome)
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3rd post-operative day
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Liver allografts: Postoperative biliary complications
Time Frame: within 1 year
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Liver allografts: Amount and type of postoperative biliary complications: stricture at anastomosis, bile leak, ischaemic type biliary lesions (ITBL)
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within 1 year
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Liver allografts: Posttransplantation kidney injury
Time Frame: within 1 week, at 3 months, 1 year
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Liver allografts: Posttransplantation kidney injury (acute kidney injury) according to ADQI (2010) criteria
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within 1 week, at 3 months, 1 year
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Liver allografts: BPAR
Time Frame: within 1 year
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Liver allografts: Biopsy proven acute rejection
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within 1 year
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Liver allografts: graft survival
Time Frame: at 1 year, 2 year, 5 year, 10 year, and 20 year
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Liver allografts: graft survival: time from transplantation to death, retransplantation or explantation
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at 1 year, 2 year, 5 year, 10 year, and 20 year
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Pancreas allografts: HbA1c
Time Frame: at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Pancreas allografts: blood HbA1c measurement
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at 3 months, 1 year, 2 year, 5 year, 10 year, and 20 year
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Pancreas allografts: Acute rejection
Time Frame: within 1 year
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Pancreas allografts: Either biopsy proven (allograft pancreas or duodenal biopsy) acute rejection or clinically treated suspected acute rejection
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within 1 year
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Pancreas allografts: Pancreatic allograft survival
Time Frame: at 1 year, 2 year, 5 year, 10 year, and 20 year
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Pancreas allografts: Time from transplantation to death, retransplantation, explantation or daily insulin dependance
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at 1 year, 2 year, 5 year, 10 year, and 20 year
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Pancreas allografts: Death-censored Pancreatic allograft survival
Time Frame: at 1 year, 2 year, 5 year, 10 year, and 20 year
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Pancreas allografts: Time from transplantation to retransplantation, explantation or daily insulin dependance, death-censored
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at 1 year, 2 year, 5 year, 10 year, and 20 year
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Heart allograft: TnI at 6 hours
Time Frame: at 6 hours
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Heart allograft: blood TnI measurement at 6 hours after transplantation
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at 6 hours
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Heart allograft: proBNP at 1 week
Time Frame: at 1 week
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Heart allograft: blood proBNP measurement at 1 week after transplantation (12/09/2019 BNP changed to proBNP because of changes in Helsinki University Hospital HUSlab laboratory protocols)
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at 1 week
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Heart allograft: Primary graft dysfunction
Time Frame: within 24 hours after transplantation
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Heart allograft: Primary graft dysfunction according to ISHLT (2014)
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within 24 hours after transplantation
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Heart allograft: acute rejection
Time Frame: within 1 year
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Heart allograft: Biopsy proven or clinically treated acute rejection
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within 1 year
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Heart allograft: Vasculopathy-free survival
Time Frame: at 1 year, 2 year, 5 year, 10 year, and 20 year
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Heart allograft: Vasculopathy-free survival according to Mehra (2010)
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at 1 year, 2 year, 5 year, 10 year, and 20 year
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Heart allograft: graft survival
Time Frame: at 1 year, 2 year, 5 year, 10 year, and 20 year
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Heart allograft: time from transplantation to death, retransplantation or explantation
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at 1 year, 2 year, 5 year, 10 year, and 20 year
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Lung allograft: Primary graft dysfunction
Time Frame: within 72 hours
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Lung allograft: Primary graft dysfunction according to ISHLT
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within 72 hours
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Lung allograft: Acute rejection
Time Frame: within 1 year
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Lung allograft: Biopsy proven or clinically treated acute rejection
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within 1 year
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Lung allograft: CLAD-free survival
Time Frame: at 1 year, 2 year, 5 year, 10 year, and 20 year
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Lung allograft: Chronic Lung Allograft Dysfunction (CLAD) free survival according to Verleden (2014)
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at 1 year, 2 year, 5 year, 10 year, and 20 year
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Lung allograft: graft survival
Time Frame: at 1, 2, 5, 10 and 20 year
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Lung allograft: time from transplantation to death, retransplantation or explantation (12/16/2019 secondary outcome measures for lung recipients redifined.
Lung recipients recruitment started later than for other organs because of a conflicting trial which now has completed recruiting.
Only four lung patients have thus far been included in the study and no results for lung recipients have been analyzed.)
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at 1, 2, 5, 10 and 20 year
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Exploratory outcomes Kidney allograft miR-21
Time Frame: peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Measurement of reperfusion injury in blood and urine samples micro-RNA miR-21
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peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Exploratory outcomes Kidney allograft miR-24
Time Frame: peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Measurement of reperfusion injury in blood and urine samples micro-RNA miR-24
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peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Exploratory outcomes Kidney allograft NGAL
Time Frame: peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Measurement of reperfusion injury in blood and urine samples neutrophil gelatinase associated lipocain NGAL
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peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Exploratory outcomes Kidney allograft KIM-1
Time Frame: peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Measurement of reperfusion injury in blood and urine samples kidney injury molecule -1 KIM-1
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peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Exploratory outcomes Kidney allograft FABP-1
Time Frame: peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Measurement of reperfusion injury in blood and urine samples fatty acid binding protein -1 FABP-1
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peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Exploratory outcomes Kidney allograft SLPI
Time Frame: peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Measurement of reperfusion injury in blood and urine samples secretory leucocyte proteinase inhibitor SLPI
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peroperative blood samples before and after graft perfusion and urinary sample 6 hours after transplantion
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Exploratory outcomes Liver allograft: Early allograft dysfunction
Time Frame: at 7 days
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Exploratory outcomes Liver allograft: Early allograft dysfunction according to Olthoff (Bil >100, INR 1.6 or more, ALT or AST > 2000 at 7th POD
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at 7 days
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Exploratory outcomes Liver allograft: Highest ALT within 7th POD
Time Frame: within 7 days
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Exploratory outcomes Liver allograft: The highest ALT measurement within 7th POD
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within 7 days
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Exploratory outcomes Liver allograft: Highest INR within 7th POD
Time Frame: within 7 days
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Exploratory outcomes Liver allograft: The highest INR measurement within 7th POD
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within 7 days
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Exploratory outcomes Liver allograft: Highest Bil within 7th POD
Time Frame: within 7 days
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Exploratory outcomes Liver allograft: The highest Bil measurement within 7th POD
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within 7 days
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Exploratory outcomes heart allografts: TnI
Time Frame: at 1 hour, 12 hours and 24 hours
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Exploratory outcomes heart allografts: TnI measurement
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at 1 hour, 12 hours and 24 hours
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Exploratory outcomes heart allografts: proBNP
Time Frame: at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: (12/09/2019 BNP changed to proBNP because of changes in Helsinki University Hospital HUSlab laboratory protocols)
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at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: crea
Time Frame: at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: crea
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at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: urea
Time Frame: at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: urea
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at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: eGFR
Time Frame: at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: eGFR
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at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: LVEF
Time Frame: at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: left ventricle ejection fraction
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at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: LV wall thickness
Time Frame: at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: left ventricle wall thickness measurements
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at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: tricuspidal leak
Time Frame: at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: grading of the tricuspidal valve leak
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at 1 day, 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: Ischaemia-reperfusion injury
Time Frame: at 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: The appearance of ischaemia-reperfusion injury in routine biopsies
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at 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: fibrosis
Time Frame: at 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: The appearance of fibrosis associated factors in routine biopsies
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at 7 days, 14 days and 21 days
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Exploratory outcomes heart allografts: long time follow-up of proBNP
Time Frame: at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes heart allografts: long time follow-up of proBNP (12/09/2019 BNP changed to proBNP because of changes in Helsinki University Hospital HUSlab laboratory protocols)
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at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes heart allografts: long time follow-up of LVEF
Time Frame: at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes heart allografts: long time follow-up of left ventricle ejection fraction in cardiac ECHO
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at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes heart allografts: CAD at 1 year
Time Frame: at 1 year
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Exploratory outcomes heart allografts: Coronary Artery Disease in coronary angiography at 1 year
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at 1 year
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Exploratory outcomes heart allografts: MACE
Time Frame: at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes heart allografts: Major Adverse Cardiac Events (including death because of cardiac cause, graft loss, primary allograft dysfunction, rejection classified as 2R or more)
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at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes lung allografts: Severity of ischaemia/reperfusion injury standardized P/F-ratio
Time Frame: at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Severity of ischemia/reperfusion injury after transplantation: standardized P/F-ratio during mechanical ventilation
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at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Exploratory outcomes lung allografts: Severity of ischaemia/reperfusion injury: non-standardized P/F-ratio
Time Frame: at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Severity of ischemia/reperfusion injury after transplantation: non-standardized P/F-ratio during mechanical ventilation
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at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Exploratory outcomes lung allografts: Severity of ischaemia/reperfusion injury: lactate
Time Frame: at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Severity of ischemia/reperfusion injury after transplantation , plasma lactate,
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at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Exploratory outcomes lung allografts: Severity of ischaemia/reperfusion injury: CRP
Time Frame: at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Severity of ischemia/reperfusion injury after transplantation: serum highly sensitive C-reactive protein
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at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Exploratory outcomes lung allografts: Severity of ischaemia/reperfusion injury: leuc
Time Frame: at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Severity of ischemia/reperfusion injury after transplantation blood leukocyte count
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at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Exploratory outcomes lung allografts: Severity of ischaemia/reperfusion injury: neut
Time Frame: at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Severity of ischemia/reperfusion injury after transplantation neutrophil count
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at 0 hours, 1 hour, 6 hours, 12 hours and 24 hours
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Exploratory outcomes lung allografts: FEV1
Time Frame: at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes lung allografts: FEV1
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at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes lung allografts: FVC
Time Frame: at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes lung allografts: FVC
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at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes lung allografts: chronic rejection
Time Frame: at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes lung allografts: chronic rejection
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at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes lung allografts: infections
Time Frame: at 1 month, 3 months, 6 months, 12 months
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Exploratory outcomes lung allografts: infections after transplantation
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at 1 month, 3 months, 6 months, 12 months
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Aki Uutela, MD, Helsinki University Central Hospital
- Study Chair: Marko Lempinen, MD, PhD, Helsinki University Central Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- RIPTRANS
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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