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Review
. 2024 Jul 5;86(9):5455-5460.
doi: 10.1097/MS9.0000000000002306. eCollection 2024 Sep.

Effectiveness of remote ischemic preconditioning in patients undergoing transplant surgery: meta-analysis of randomized control studies

Ameer Fadhel Abbas  1 , Haania Shahbaz  2 , Armand Gumera  3 , Ali Saad Al-Shammari  4 , Mohanad Mahdey Salih Alchamaley  1 , Hashim Talib Hashim  5 , Mohannad Abdeltawwab  6 , Mahmoud Amin  6
Affiliations
Review

Effectiveness of remote ischemic preconditioning in patients undergoing transplant surgery: meta-analysis of randomized control studies

Ameer Fadhel Abbas et al. Ann Med Surg (Lond). .

Abstract

Introduction: Remote ischemic preconditioning (RIPC) is a phenomenon in which the induction of shortened periods of ischemia prior to surgical procedures within a distant tissue preserves other tissues or organs of concern, such as the liver or kidney in transplant surgery, in the event of prolonged ischemic insults. The authors aim to evaluate the effectiveness of RIPC in patients undergoing transplant surgery, specifically kidney and liver transplants.

Materials and methods: PubMed, Embase, and Scopus were searched until 19 December 2023 for trials evaluating RIPC in patients undergoing transplant surgery. A total of 9364 search articles were obtained, which yielded 10 eligible studies. Data analysis was done using RevMan 5.4 software. The risk of bias was done using Cochrane risk of bias tool.

Results and discussion: For graft rejection, the study observed a relative risk of 0.99 (95% CI, 0.49-1.98, P=0.97) from 5 trials, indicating no significant effect of RIPC on graft survival in both kidney and liver transplants. The length of hospital stay also showed no significant decrease for those undergoing RIPC, with mean difference (MD) of -0.58 (95% CI, -1.38 to 0.23, P=0.16). GFR at 1-year post-kidney transplant did not significantly change in the RIPC group compared to controls, as evidenced by an MD of -0.13 (95% CI, -3.79 to 3.54, P=0.95). These results collectively suggest that RIPC may not be effective in reducing patient, or graft, outcomes.

Keywords: RIC; RIPC; kidney transplant; organ transplantation; remote ischemic preconditioning; transplant.

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Conflict of interest statement

The authors involved in this review certify that they have no conflict of interest, affiliations with or involvement in any organization or entity with any financial interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Flow chart of study selection and search result based on Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020.
Figure 2
Figure 2
Forest plot of comparison: RIPC vs. control, outcome: graft rejection. RIC, remote ischemic preconditioning.
Figure 3
Figure 3
Forest plot of comparison: RIPC vs. control, outcome: length of hospital stay. RIC, remote ischemic preconditioning.
Figure 4
Figure 4
Forest plot of comparison: RIPC vs. control, outcome: glomerular filtration rate at 1 year. RIC, remote ischemic preconditioning.
See this image and copyright information in PMC

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