ADVANCED RECOVERY ROOM CARE VS STANDARD OF CARE IN LIVING DONOR KIDNEY TRANSPLANTATION: A PILOT RANDOMISED CONTROLLED TRIAL
Karthik Venkataraman1, MICHAEL COLLINS2, GUY LUDBROOK3, TOBY COATES1 1University Of Adelaide, Adelaide, SA, Australia2Central and Northern Adelaide Renal and Transplantation Service, Adelaide, SA, Australia3Advanced Recovery Room Centre, Adelaide, SA, Australia
Abstract
Background: The optimum method to manage patients post renal transplantation is unknown. Significant heterogeneity exists in practice, with transplanting centres managing patients post operatively in intensive care units, high dependency units and renal wards. No comparative data exists to inform practices. The advanced recovery room is a model of post operative recovery, designed to provide high dependency unit level of care to patients.
Methodology: We have designed a pilot open-label randomised controlled trial (RCT), randomising recipients of living donor transplantation in a 1:1 ratio to either post operative care in the Advanced Recovery Room Care (ARRC) at the Royal Adelaide Hospital or the current standard of care, which is management on the renal ward. The intervention will include the ARRC bundle of care, involving closer haemodynamic monitoring, more frequent medical officer review and the ability to assess and address post operative hypotension with fluids and vasopressors.
Outcomes: The primary outcomes are 1) safety, defined by adverse events assessed by the Severity Assessment Code (SAC), 2) feasibility, assessed by recruitment percentage and adherence to protocol. The primary efficacy endpoint is the mean difference in 24 hour blood pressure between groups.
Conclusions: This is the first RCT investigating the level of post operative care in renal transplantation. Results from this RCT will lay the foundation for future trials, designed to assess the optimum post operative care of patients undergoing renal transplantation.
Biography
Dr Karthik Venkataraman is a PhD candidate and Nephrology Advanced Trainee. After completing 2 years of advanced training in renal medicine, her has currently interuppted training to undertake a higher degree. His research interest is in peri-operative management of renal transplants. Karthik’s research is kindly supported by a scholarship by Kidney Transplant Diabetes Research Australia.