Transplant Trial Watch

Effects of Desflurane and Sevoflurane anesthesia on regulatory T cells in patients undergoing living donor kidney transplantation: a randomized intervention trial.

Chutipongtanate, A., et al.

BMC Anesthesiology 2020; 20(1): 215.

The aim of this study was to examine the effects of desflurane versus sevoflurane anesthesia on peripheral blood regulatory T-cells in living donor renal transplant patients.

Patients were randomized to either the desflurane group or the sevoflurane group.

46 living donor kidney transplant patients.

The primary endpoint was the assessment of absolute change in the number of peripheral blood CD4+CD25+FoxP3+Tregs. The secondary endpoint was the plasma level of anti-inflammatory cytokine IL-10, TGF-β1, and proinflammatory cytokines produced by T helper (Th) 1/Th2.

24 hours

CET Conclusions
This interesting study investigated the effects of volatile anesthetic agents (sevoflurane vs. desflurane) on peripheral blood T-regulatory cells in living donor kidney transplant recipients. T-reg cells were upregulated more in the desflurane group at 24 hours post-transplant, leading the authors to suggest that use of desflurane may be beneficial. Methodology was reasonable, although the study protocol was registered after recruitment had started. Outcome assessors and patients were blinded, but the anesthetist was presumably not, which does raise the risk of performance bias during anesthesia. The clinical significance of the small increase in T-reg levels seen is uncertain, but would certainly warrant larger studies with clinical endpoints.

Jadad score

Data analysis
Per protocol analysis

Allocation concealment

Trial registration - NCT02559297

Funding source
Non-industry funded