A randomised trial of antibiotics in laparoscopic donor nephrectomy
ISRCTN | ISRCTN71141360 |
---|---|
DOI | https://doi.org/10.1186/ISRCTN71141360 |
EudraCT/CTIS number | 2012-000942-36 |
ClinicalTrials.gov number | NCT02089568 |
Secondary identifying numbers | 13238 |
- Submission date
- 08/01/2015
- Registration date
- 09/01/2015
- Last edited
- 28/05/2020
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Urological and Genital Diseases
Plain English summary of protocol
Plain English summary under review
Contact information
Scientific
Renal Unit
Guy's Hospital
Great Maze Pond
London
SE1 9RT
United Kingdom
Study information
Study design | Randomised; Interventional; |
---|---|
Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Hospital |
Study type | Treatment |
Participant information sheet | Not available in web format, please use the contact details to request a patient information sheet |
Scientific title | Are prophylactic antibiotics necessary before laparoscopic living kidney donation? A double blind, randomised, controlled trial |
Study acronym | PoWAR |
Study objectives | Around two-thirds of all kidney transplants in the UK are performed using kidneys from living kidney donors; these are indviduals who have volunteered to donate one of their kidneys. Every attempt is made to minimise the risk of complications in these patients, who do not have any need to undergo surgery. We know that a significant number (10-15%) of these patients will have infections (such as infections of their surgical wound, urinary infections or chest infections) after surgery. These infections may lead to a longer time spent in hospital, re-attendance at the hospital, GP or local Emergency department after discharge and a longer recovery time. Most donors are working and a delay in returning to work is important to them. Infections may cause significant discomfort and anxiety. Costs are increased (threefold) due to the longer hospital stay. A single dose of antibiotics given at the start of surgery is often used to prevent surgical site infections. However, whether this is beneficial for living donors has not been tested. Patients undergoing bowel surgery for example, are usually ill (donors are healthy) and bowel surgery is regarded as a 'contaminated' operation, due to the bacteria within the gut. Living kidney donation however may not involve potential contamination with bacteria. If antibiotics are used unnecessarily, consequences include side effects, such as diarrhoea and allergic reactions (which can be serious), the spread of resistance to antibiotics, and an extra cost. We are therefore proposing a trial which will compare the risk of infections, side effects, hospital stay and costs in those who receive a dose of antibiotics and those who receive a placebo (which would be an injection of salt water). The patients will be randomised by a computer to one or other treatment, and patients will be followed for one month after surgery. We expect that the findings will be easy to implement across the UK for living donors. |
Ethics approval(s) | 12/LO/0877 |
Health condition(s) or problem(s) studied | Topic: Renal disorders; Subtopic: Renal disorders; Disease: All Renal disorders |
Intervention | A single intravenous dose (1.2g) of the IMP (or placebo) will be given at induction of anaesthesia. |
Intervention type | Drug |
Pharmaceutical study type(s) | |
Phase | Not Applicable |
Drug / device / biological / vaccine name(s) | |
Primary outcome measure | The primary outcome measure will be a composite endpoint of any infection; this will include surgical site infections as well as urinary tract, respiratory and any other infections, within 30 days of surgery. |
Secondary outcome measures | 1. Ultrasonic evidence of wound healing 2. Length of hospital stay 3. Readmission rates 4. Antibiotic associated side effects (including diarrhoea and allergic reactions), return to work and normal activities 5. Quality of life and relative costs |
Overall study start date | 01/01/2013 |
Completion date | 30/04/2016 |
Eligibility
Participant type(s) | Patient |
---|---|
Age group | Adult |
Lower age limit | 18 Years |
Sex | Both |
Target number of participants | Planned Sample Size: 284; UK Sample Size: 284 |
Total final enrolment | 295 |
Key inclusion criteria | 1. All adult patients (over 18 years) undergoing hand-assisted laparoscopic donor nephrectomy, who have given written informed consent, will be included 2. Patients whose first language is not English will be included; they comprise a significant part of our patient population and we will use translation services as is our normal practice 3. Women of child-bearing age taking adequate contraception will be included |
Key exclusion criteria | 1. Patients with a known allergy to penicillin or other antibiotics 2. Patients with MRSA colonisation 3. Participation in another investigational study within the previous 90 days 4. Pregnant or breastfeeding women |
Date of first enrolment | 01/01/2013 |
Date of final enrolment | 31/12/2015 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
Great Maze Pond
London
SE1 9RT
United Kingdom
Sponsor information
Hospital/treatment centre
Research & Development Dept 2nd Floor Conybeare House
Great Maze Pond
London
SE1 9RT
England
United Kingdom
https://ror.org/00j161312 |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
- Location
- United Kingdom
Results and Publications
Intention to publish date | |
---|---|
Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Not provided at time of registration |
Publication and dissemination plan | Not provided at time of registration |
IPD sharing plan |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
---|---|---|---|---|---|
Basic results | 28/05/2020 | No | No | ||
HRA research summary | 28/06/2023 | No | No |
Editorial Notes
28/05/2020: The following changes were made to the trial record:
1. Added clinicaltrialsregister.eu link to basic results (scientific).
2. The total final enrollment was added.
23/07/2019: ClinicalTrials.gov number added. No publications found in PubMed, verifying study status with principal investigator.
16/05/2018: No publications found, verifying study status with principal investigator.