Clinical Trials Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2021; 27(4): 345-357
Published online Jan 28, 2021. doi: 10.3748/wjg.v27.i4.345
Effect of remote ischemic preconditioning among donors and recipients following pediatric liver transplantation: A randomized clinical trial
Bo Qi, Xiao-Qiang Wang, Shu-Ting Pan, Pei-Ying Li, Ling-Ke Chen, Qiang Xia, Li-Qun Yang, Wei-Feng Yu
Bo Qi, Xiao-Qiang Wang, Pei-Ying Li, Ling-Ke Chen, Li-Qun Yang, Wei-Feng Yu, Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Shu-Ting Pan, Clinical Center for Investigation, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Qiang Xia, Department of Transplantation and Hepatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China
Author contributions: Qi B and Wang XQ contributed equally to this work; Yang LQ and Yu WF contributed to conceptualization and formal analysis; Qi B, Wang XQ, Pan ST and Li PY contributed to data curation and statistical analysis; Wang XQ, Yang LQ and Chen LK contributed to drafting and editing the manuscript; Yu WF and Xia Q contributed to review and editing.
Supported by Renji Hospital Clinical Innovation Foundation, No. PYIII-17-002; Outstanding Academic Leaders’ Program of Health and Family Planning Commission of Shanghai, No. 2017BR042; and Investigative Doctor Program (2017) of Shanghai Jiao Tong University School of Medicine; and Joint Project of Health and Family Planning Commission of Pudong District, No. PW2015D-3.
Institutional review board statement: The study was reviewed and approved by the Renji Hospital Institutional Review Board (Approval No. 2016-002K).
Clinical trial registration statement: This study is registered at The registration identification number is NCT02830841.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wei-Feng Yu, PhD, Chief Doctor, Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Road, Shanghai 200127, China.
Received: October 29, 2020
Peer-review started: October 29, 2020
First decision: November 30, 2020
Revised: December 9, 2020
Accepted: December 26, 2020
Article in press: December 26, 2020
Published online: January 28, 2021
Research background

Studies suggested that remote ischemic preconditioning (RIPC) may effectively lessen the harmful effects of ischemia reperfusion injury (IRI) during organ transplantation surgery. However, the effect of RIPC on pediatric liver transplantation (LT) was still unknown.

Research motivation

To investigate the protective effects of RIPC on living liver donors and recipients following pediatric LT.

Research objectives

We performed this single-center randomized clinical trial to determine whether RIPC could be beneficial in reducing IRI among both donors and recipients undergoing pediatric living LT.

Research methods

Two-hundred-eight donors were recruited and randomly assigned to four groups: S-RIPC group (no intervention), D-RIPC group (donors received RIPC), R-RIPC group (recipients received RIPC) and DR-RIPC group (both donors and recipients received RIPC). We primarily evaluated postoperative liver function among donors and recipients and incidences of early allograft dysfunction (EAD), primary nonfunction (PNF) and postoperative complications among recipients.

Research results

RIPC did not significantly improve alanine transaminase and aspartate aminotransferase levels among donors and recipients and decrease incidences of EAD, PNF and postoperative complications among recipients. Furthermore, RIPC had no effects on the overall survival of recipients.

Research conclusions

The protective effects of RIPC were limited for recipients who received living LT, and no significant improvement of the prognosis was observed in recipients.

Research perspectives

Our research suggested that RIPC may have limited beneficial effects for recipients undergoing LT as well as donors. Nonetheless, more clinical trials regarding the effects of RIPC on pediatric LT are warranted.