Use of a Muscle Pump Activator Leads to Improved Lower Limb Edema, Lower Limb Blood Flow, and Urine Output Compared With Standard TED Stockings and Compression Devices Following Kidney Transplant: A Randomized Controlled Trial.Aquil, S., Alharbi, B. et al. (2019).
Transplantation Proceedings; [record in progress].
This study aimed to evaluate the effects of using thromboembolic deterrent (TED) stockings and intermittent pneumatic compression (IPC) vs a muscle pump activator (MPA) device on limb oedema and patient satisfaction after transplant.
Patients were randomly assigned to wear TED + IPC (n=64) or the MPA device (n = 54) from postoperative days 1 to 6.
118 kidney transplant patients.
The primary outcome asssesed patient lower limb oedema after surgery and patient satisfaction with the MPA device vs TED + IPC stockings following kidney transplant. Secondary outcomes included: weight gain, DVT risk, total urine output, kidney function, and kidney blood flow.
This small RCT from Ontario investigates the use of a muscle pump activator as an alternative to TEDs and intermittent pneumatic compression as DVT prophylaxis following renal transplantation. The authors report a reduction in gain of leg circumference, increased urine output, and reduction in weight gain in the MPA group. In addition, patients found MPA more comfortable. The study is well designed and clearly reported. Randomization and allocation concealment were adequate, and there was no loss to follow-up. It is not blinded, and therefore risks reporting bias in the patient reported outcome measures, although blinding would be difficult. Larger studies would be required to confirm that MPA is equivalent to IPC and TEDs in the prevention of DVT.