{
  "abstract": "Introduction Ischaemia reperfusion injury (IRI) is inevitable in kidney transplantation and negatively affects patient and graft outcomes. Anaesthetic conditioning (AC) refers to the use of anaesthetic agents to mitigate IRI. AC is particularly associated with volatile anaesthetic (VA) agents and to a lesser extent to intravenous agents like propofol. VA like sevoflurane interferes with many of the processes underlying IRI and exerts renal protective properties in various models of injury and inflammation. We hypothesise that a sevoflurane-based anaesthesia is able to induce AC and thereby reduce post-transplant renal injury, reflected in improved graft and patient outcome, compared with a propofol-based anaesthesia in transplant recipients of a deceased donor kidney.Methods and analysis Investigator-initiated, multicentre, randomised, controlled and prospective clinical trial with two parallel groups. The study will include 488 kidney transplant recipients from donation after brain death (DBD) or donation after circulatory death (DCD) donors. Participants are randomised in a 1:1 design to a sevoflurane (intervention) or propofol (control) group. The primary endpoint is the incidence of delayed graft function in recipients of DCD and DBD donor kidneys and/or 1-year biopsy-proven and treated acute rejection. Secondary endpoints include functional delayed graft function defined as failure of serum creatinine levels to decrease by at least 10% per day for three consecutive days; primary non-function is defined as a permanent lack of function of the allograft; length of hospital stay and postoperative complications of all kinds, estimated glomerular filtration rate at 1 week and 3 and 12 months calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula; readmissions at 3 and 12 months, graft survival and all-cause mortality at 12 months.Ethics and dissemination The study is approved by the local ethical committees and national data security agencies. Results are expected to be published in 2025.Trial registration number NCT02727296.",
  "authors": [
    {
      "affiliations": [
        "Department of Anaesthesiology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands"
      ],
      "name": "Gerrie Joelle Julia Huisman"
    },
    {
      "affiliations": [
        "Department of Nephrology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands"
      ],
      "name": "Stefan P Berger"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark",
        "Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark"
      ],
      "name": "Peter S Thyrrestrup"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway"
      ],
      "name": "John Hausken"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Amsterdam UMC (AUMC), Amsterdam University Medical Centres, Amsterdam, Noord-Holland, Netherlands"
      ],
      "name": "Denise P Veelo"
    },
    {
      "affiliations": [
        "Department of Nephrology, Universitat Autònoma de Barcelona, Barcelona, Spain"
      ],
      "name": "Luis Guirado"
    },
    {
      "affiliations": [
        "Department of Surgery, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands"
      ],
      "name": "Robert Pol"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark"
      ],
      "name": "Luana L Jensen"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway"
      ],
      "name": "Tor Inge Tønnessen"
    },
    {
      "affiliations": [
        "Department of Nephrology, Amsterdam UMC (AUMC), Amsterdam University Medical Centres, Amsterdam, Netherlands"
      ],
      "name": "Frederike J Bemelman"
    },
    {
      "affiliations": [
        "Department of Nephrology, Fundacio Puigvert, Barcelona, Catalunya, Spain"
      ],
      "name": "Carme Facundo"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Department of Nephrology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark",
        "Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark",
        "Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway",
        "Department of Anaesthesiology, Amsterdam UMC (AUMC), Amsterdam University Medical Centres, Amsterdam, Noord-Holland, Netherlands",
        "Department of Nephrology, Universitat Autònoma de Barcelona, Barcelona, Spain",
        "Department of Surgery, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark",
        "Department of Nephrology, Amsterdam UMC (AUMC), Amsterdam University Medical Centres, Amsterdam, Netherlands",
        "Department of Nephrology, Fundacio Puigvert, Barcelona, Catalunya, Spain",
        "Department of Neurosurgery, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Department of Epidemiology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Cross-connection Research-Clinical Trial Hub, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium"
      ],
      "name": "THE VAPOR-2 STUDY GROUP"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Department of Epidemiology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Cross-connection Research-Clinical Trial Hub, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands"
      ],
      "name": "Katalin Tamasi"
    },
    {
      "affiliations": [
        "Department of Epidemiology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands"
      ],
      "name": "Gerton Lunter"
    },
    {
      "affiliations": [
        "Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark"
      ],
      "name": "Bente Jespersen"
    },
    {
      "affiliations": [
        "Department of Surgery, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands"
      ],
      "name": "Henri G D Leuvenink"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands",
        "Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium"
      ],
      "name": "Michel M R F Struys"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands"
      ],
      "name": "Gertrude J Nieuwenhuijs-Moeke"
    }
  ],
  "title": "Propofol-based versus sevoflurane-based anaesthesia for deceased donor kidney transplantation: the VAPOR-2 study protocol for an international multicentre randomised controlled trial",
  "uid": "695d559f-3d73-5d68-9b3b-a190d91464a4"
}