Superior markers of kidney dysfunction at liver transplant assessment

• Research type

  Research Study

• Full title

  Superior markers of kidney dysfunction in patients admitted for liver transplant assessment could improve both short and long-term outcomes.

• IRAS ID

  235377

• Contact name

  Jonathan Fallowfield

• Contact email

  Jonathan.Fallowfield@ed.ac.uk

• Sponsor organisation

  University of Edinburgh

• Duration of Study in the UK

  1 years, 6 months, 0 days

• Research summary

  Kidney dysfunction before and immediately after liver transplantation is common and leads to poorer outcomes, including prolonged need for post-operative intensive care, diminished graft survival, and greater risk of permanent kidney dysfunction and death. Blood creatinine level - the standard measure of kidney function - is suboptimal in people with advanced liver disease, overestimating kidney function by >20%. There is significant concern that liver transplant recipients are at higher risk of acute kidney injury (AKI) than we can currently predict. This study aims to identify superior tests (blood/urine or imaging) for kidney dysfunction, to enable improved treatment and patient outcomes.
  This study aims to recruit 80-100 consecutive patients admitted to the Scottish Liver Transplant Unit (SLTU), Royal Infirmary of Edinburgh (RIE) for liver transplant assessment over a 6 month period. Permission will be sought to record the results of routine tests performed by the NHS during this assessment week. In addition, we will invite participants to attend the RIE clinical research facility (CRF) for a single visit (~2 hours) to perform extra research assessments. Blood and urine will be collected for biomarker analysis. Non-invasive assessment of cardiovascular function will be completed using cardiac bio-impedance and aortic pulse wave velocity. Examination of the blood vessels at the back of the eye will be performed using optical coherence tomography.
  A subgroup of 10 participants will undergo magnetic resonance imaging (MRI) of the kidneys using arterial spin labelling to identify dysregulated renal perfusion.
  Patients who are transplanted during the study timeframe will be asked to re-attend the CRF for repeat assessments at 6 weeks post transplantation.
  Funded by Scottish Liver Transplant Unit Endowment Fund

• REC name

  North West - Haydock Research Ethics Committee

• REC reference

  17/NW/0692

• Date of REC Opinion

  8 Dec 2017

• REC opinion

  Favourable Opinion