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NephrectomyNCT03717259

Recovery of Short-term Renal Function in Post-transplant Patients Living Donor

A study testing Open nephrectomy, Hand-assisted laparoscopic nephrectomy and Laparoscopic nephrectomy in people with Nephrectomy, run by Instituto Mexicano del Seguro Social.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Objectives: To describe and analyze the perioperative and functional evolution of short-term renal graft in patients with kidney transplantation from a live donor, comparing three surgical techniques for obtaining kidney graft: open nephrectomy, laparoscopic hand-assisted nephrectomy, and pure laparoscopic nephrectomy. Read more about this study

Who is it for?
Any age
Conditions the study is for
Nephrectomy
What is being tested?
Open nephrectomy, Hand-assisted laparoscopic nephrectomy and Laparoscopic nephrectomy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
508 participants
Where
No sites listed yet
Study dates
1 Jan 2016to 30 Dec 2017
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients with terminal chronic kidney disease who will receive a kidney transplant in the transplant service of the National Medical Center of the West of living donor related to the means of obtaining the kidney graft by laparoscopic hand assisted or pure laparoscopic surgery.

Who cannot join

  • Patients who for some reason can not find your complete medical record.
  • Patients obtained a kidney graft from a brain death donor.

About this study

Official title: Recovery of Short-term Renal Function in Post-transplant Patients Living Donor: Comparison Between Graft Procurement Techniques - Open Surgery, Laparoscopic Assisted Hand and Pure Laparoscopic

Objectives: To describe and analyze the perioperative and functional evolution of short-term renal graft in patients with kidney transplantation from a live donor, comparing three surgical techniques for obtaining kidney graft: open nephrectomy, laparoscopic hand-assisted nephrectomy, and pure laparoscopic nephrectomy.

Read the detailed description

Analytical cross-sectional study that will compare the three renal graft procurement techniques: open nephrectomy, laparoscopic hand-assisted nephrectomy, and pure laparoscopic nephrectomy. The investigators will analyze serum creatinine values on days 1, 5 and 28 post renal transplantation. The operative, medical and surgical morbidity will also be evaluated, considering the bleeding in the donor, times of ischemia and the need for JJ catheter placement in the recipient.

Conditions
Nephrectomy
Being tested
Open nephrectomy, Hand-assisted laparoscopic nephrectomy, Laparoscopic nephrectomy
Keywords
Renal Donation, Renal Transplant, Open Nephrectomy, Laparoscopic Nephrectomy, Hand Assisted, Surgical Morbidity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Open nephrectomyProcedure or surgery

    The surgical technique for open nephrectomy consists of placing the donor in the lateral decubitus position and making an incision with or without rib resection that allows retroperitoneal access.

  • Hand-assisted laparoscopic nephrectomyProcedure or surgery

    The hand-assisted technique begins with the incision for the introduction port of the hand, the renal artery and vein are divided using endoscopic staples and the graft is manually removed.

  • Laparoscopic nephrectomyProcedure or surgery

    In the pure laparoscopic technique the patient is placed in the same position of lateral decubitus and after introducing the trocars in the abdomen, the colon is mobilized and the renal capsule is divided, the kidney is removed after performing the cut of the renal artery and vein through a suprapubic incision.

Study groups in NCT03717259
Study groupRoleWhat they receive
Open nephrectomyActive comparatorThese patients will undergo an open nephrectomy.
Receives: Procedure: Open nephrectomy
Hand-assisted laparoscopic nephrectomyActive comparatorThese patients will undergo a hand-assisted nephrectomy.
Receives: Procedure: Hand-assisted laparoscopic nephrectomy
Laparoscopic nephrectomyActive comparatorThese patients will undergo a pure laparoscopic nephrectomy.
Receives: Procedure: Laparoscopic nephrectomy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rate of medical complications in renal graft recipients through 30 day after the nephrectomy.

    The investigators will evaluate the presence of surgical and medical complications in renal graft recipients obtained by open nephrectomy, hand assisted nephrectomy, and pure laparoscopic nephrectomy.

    Measured: Through 30 days post surgery.

Secondary outcomes (6)
  1. Days of hospital stay

    Differences in the days of hospital stay of the renal donor comparing the techniques used to obtain the graft.

    Measured: 30 days after the nephrectomy.

  2. Bleeding during the nephrectomy

    The investigators will measure the volume of bleeding.

    Measured: Through the nephrectomy

  3. JJ catheter placement

    The investigators will describe the number of patients who underwent a JJ catheter.

    Measured: Perioperative (5 days post surgery)

  4. Serum creatinine

    Measurement of serum creatinine in kidney transplant patients.

    Measured: Days post trasplant 1, 5 and 28.

  5. Duration of the nephrectomy in minutes

    The investigators will measure how long the nephrectomies lasts

    Measured: Minutes from the beginning to the end of the nephrectomy

  6. Warm ischemia time in the graft

    The investigators will measure the time of warm ischemia during nephrectomy

    Measured: Time in minutes between the clamping of the renal vessels and the cooling of the graft with the preservation liquid at 4º C

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Oct 2018
  2. Study start1 Jan 2016
  3. Primary completion1 Dec 2017
  4. Study completion30 Dec 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Crossover
Model description
This is an analytical cross-sectional study for which patients with terminal chronic kidney disease will be taken from kidney transplanted from a related live donor in a tertiary hospital. The selection of patients will be done with a non-probabilistic sampling of consecutive cases. Kidney transplantation from a live donor will be carried out by means of kidney graft procurement techniques using open surgery, laparoscopic hand-assisted surgery or pure laparoscopic surgery. The statistical analysis will be performed with Student´s t-test and Chi-square test. To determine if the intervening variables affected the postoperative renal function, we will perform a multivariate analysis. We will consider a significant P value when it is \<0.05.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
508 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03717259
Sponsor's protocol ID
Post_transplant_2016
Status last verified
Oct 2018
First submitted
26 Jun 2018
Last updated
24 Oct 2018
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Villeda-Sandoval CI, Rodriguez-Covarrubias F, Cortes-Aguilar G, Alberu-Gomez J, Vilatoba-Chapa M, Sotomayor M, Feria-Bernal G, Gabilondo F, Gabilondo-Pliego B. Hand-assisted laparoscopic versus open donor nephrectomy: a retrospective comparison of perioperative and functional results in a tertiary care center in Mexico. Transplant Proc. 2013 Nov;45(9):3220-4. doi: 10.1016/j.transproceed.2013.03.055.

    PubMed 24182788
  • Altinel M, Akinci S, Gunes ZE, Olcucuoglu E, Gonenc F, Yazicioglu AH. Open versus laparoscopic donor nephrectomy: perioperative parameters and graft functions. Transplant Proc. 2011 Apr;43(3):781-6. doi: 10.1016/j.transproceed.2011.01.113.

    PubMed 21486597
  • Chin EH, Hazzan D, Edye M, Wisnivesky JP, Herron DM, Ames SA, Palese M, Pomp A, Gagner M, Bromberg JS. The first decade of a laparoscopic donor nephrectomy program: effect of surgeon and institution experience with 512 cases from 1996 to 2006. J Am Coll Surg. 2009 Jul;209(1):106-13. doi: 10.1016/j.jamcollsurg.2009.02.060. Epub 2009 May 1.

    PubMed 19651070
  • Rojas-Manjarrez MA, Fernandez-Diaz OF, Sandoval-Sandoval MJ, Valdespino-Mejia C, Monteon-Ramos F, Gonzalez-Ojeda A. [Urological complications after kidney transplantation]. Cir Cir. 2008 Mar-Apr;76(2):133-7. Spanish.

    PubMed 18492434
  • Perez Fentes DA, Blanco Parra M, Toucedo Caamano V, Romero Burgos R, Punal Rodriguez JA, Varo Perez E. [Surgical complications after kidney transplantation. Research based on 185 cases]. Actas Urol Esp. 2005 Jun;29(6):578-86. doi: 10.1016/s0210-4806(05)73300-3. Spanish.

    PubMed 16092682
  • Wolf JS Jr, Tchetgen MB, Merion RM. Hand-assisted laparoscopic live donor nephrectomy. Urology. 1998 Nov;52(5):885-7. doi: 10.1016/s0090-4295(98)00389-6.

    PubMed 9801121
  • Kalble T, Lucan M, Nicita G, Sells R, Burgos Revilla FJ, Wiesel M; European Association of Urology. EAU guidelines on renal transplantation. Eur Urol. 2005 Feb;47(2):156-66. doi: 10.1016/j.eururo.2004.02.009.

    PubMed 15661409
  • Emery DL, Rothel JS, Wood PR. Influence of antigens and adjuvants on the production of gamma-interferon and antibody by ovine lymphocytes. Immunol Cell Biol. 1990 Apr;68 ( Pt 2):127-36. doi: 10.1038/icb.1990.18.

    PubMed 2116995
  • Stifelman MD, Hull D, Sosa RE, Su LM, Hyman M, Stubenbord W, Shichman S. Hand assisted laparoscopic donor nephrectomy: a comparison with the open approach. J Urol. 2001 Aug;166(2):444-8. doi: 10.1016/s0022-5347(05)65960-5.

    PubMed 11458044
  • Nogueira JM, Cangro CB, Fink JC, Schweitzer E, Wiland A, Klassen DK, Gardner J, Flowers J, Jacobs S, Cho E, Philosophe B, Bartlett ST, Weir MR. A comparison of recipient renal outcomes with laparoscopic versus open live donor nephrectomy. Transplantation. 1999 Mar 15;67(5):722-8. doi: 10.1097/00007890-199903150-00014.

    PubMed 10096529
  • Meyer F, Nichele SA, Adamy A, Santos LS, Machado C. Early outcomes of laparoscopic donor nephrectomy with multiple renal arteries. Int Braz J Urol. 2012 Jul-Aug;38(4):496-503. doi: 10.1590/s1677-55382012000400009.

    PubMed 22951178
  • Simforoosh N, Basiri A, Tabibi A, Shakhssalim N, Hosseini Moghaddam SM. Comparison of laparoscopic and open donor nephrectomy: a randomized controlled trial. BJU Int. 2005 Apr;95(6):851-5. doi: 10.1111/j.1464-410X.2005.05415.x.

    PubMed 15794797
  • Hoda MR, Hamza A, Greco F, Wagner S, Fischer K, Fornara P. Early and late graft function after laparoscopic hand-assisted donor nephrectomy for living kidney transplantation: comparison with open donor nephrectomy. Urol Int. 2010;84(1):61-6. doi: 10.1159/000273468. Epub 2010 Feb 17.

    PubMed 20173371
  • Fonouni H, Mehrabi A, Golriz M, Zeier M, Muller-Stich BP, Schemmer P, Werner J. Comparison of the laparoscopic versus open live donor nephrectomy: an overview of surgical complications and outcome. Langenbecks Arch Surg. 2014 Jun;399(5):543-51. doi: 10.1007/s00423-014-1196-4. Epub 2014 Apr 28.

    PubMed 24770877
  • Nanidis TG, Antcliffe D, Kokkinos C, Borysiewicz CA, Darzi AW, Tekkis PP, Papalois VE. Laparoscopic versus open live donor nephrectomy in renal transplantation: a meta-analysis. Ann Surg. 2008 Jan;247(1):58-70. doi: 10.1097/SLA.0b013e318153fd13.

    PubMed 18156924

Questions about this trial

What is this clinical trial studying?

A study testing Open nephrectomy, Hand-assisted laparoscopic nephrectomy and Laparoscopic nephrectomy in people with Nephrectomy, run by Instituto Mexicano del Seguro Social.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Oct 2018. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of medical complications in renal graft recipients through 30 day after the nephrectomy. (time frame: Through 30 days post surgery.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03717259, which also lists 26 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Oct 2018.

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