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dc.contributor.authorCollins, Michael G-
dc.contributor.authorFahim, Magid A-
dc.contributor.authorPascoe, Elaine M-
dc.contributor.authorDansie, Kathryn B-
dc.contributor.authorHawley, Carmel M-
dc.contributor.authorClayton, Philip A-
dc.contributor.authorHoward, Kirsten-
dc.contributor.authorJohnson, David W-
dc.contributor.authorMcArthur, Colin J-
dc.contributor.authorMcConnochie, Rachael C-
dc.contributor.authorMount, Peter F-
dc.contributor.authorReidlinger, Donna-
dc.contributor.authorRobison, Laura-
dc.contributor.authorVarghese, Julie-
dc.contributor.authorVergara, Liza A-
dc.contributor.authorWeinberg, Laurence-
dc.contributor.authorChadban, Steven J-
dc.identifier.citationTrials 2020; 21(1): 428en_US
dc.description.abstractDelayed graft function, the requirement for dialysis due to poor kidney function post-transplant, is a frequent complication of deceased donor kidney transplantation and is associated with inferior outcomes and higher costs. Intravenous fluids given during and after transplantation may affect the risk of poor kidney function after transplant. The most commonly used fluid, isotonic sodium chloride (0.9% saline), contains a high chloride concentration, which may be associated with acute kidney injury, and could increase the risk of delayed graft function. Whether using a balanced, low-chloride fluid instead of 0.9% saline is safe and improves kidney function after deceased donor kidney transplantation is unknown. BEST-Fluids is an investigator-initiated, pragmatic, registry-based, multi-center, double-blind, randomized controlled trial. The primary objective is to compare the effect of intravenous Plasma-Lyte 148 (Plasmalyte), a balanced, low-chloride solution, with the effect of 0.9% saline on the incidence of delayed graft function in deceased donor kidney transplant recipients. From January 2018 onwards, 800 participants admitted for deceased donor kidney transplantation will be recruited over 3 years in Australia and New Zealand. Participants are randomized 1:1 to either intravenous Plasmalyte or 0.9% saline peri-operatively and until 48 h post-transplant, or until fluid is no longer required; whichever comes first. Follow up is for 1 year. The primary outcome is the incidence of delayed graft function, defined as dialysis in the first 7 days post-transplant. Secondary outcomes include early kidney transplant function (composite of dialysis duration and rate of improvement in graft function when dialysis is not required), hyperkalemia, mortality, graft survival, graft function, quality of life, healthcare resource use, and cost-effectiveness. Participants are enrolled, randomized, and followed up using the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. If using Plasmalyte instead of 0.9% saline is effective at reducing delayed graft function and improves other clinical outcomes in deceased donor kidney transplantation, this simple, inexpensive change to using a balanced low-chloride intravenous fluid at the time of transplantation could be easily implemented in the vast majority of transplant settings worldwide. Australian New Zealand Clinical Trials Registry: ACTRN12617000358347. Registered on 8 March 2017. NCT03829488. Registered on 4 February 2019.en_US
dc.subjectBalanced crystalloiden_US
dc.subjectDelayed graft functionen_US
dc.subjectEnd-stage kidney diseaseen_US
dc.subjectIntravenous fluidsen_US
dc.subjectKidney transplantationen_US
dc.subjectNormal salineen_US
dc.subjectPeri-operative careen_US
dc.subjectPlasma-Lyte 148en_US
dc.subjectPragmatic trialen_US
dc.subjectRegistry trialen_US
dc.titleStudy Protocol for Better Evidence for Selecting Transplant Fluids (BEST-Fluids): a pragmatic, registry-based, multi-center, double-blind, randomized controlled trial evaluating the effect of intravenous fluid therapy with Plasma-Lyte 148 versus 0.9% saline on delayed graft function in deceased donor kidney transplantation.en_US
dc.typeJournal Articleen_US
dc.identifier.affiliationDepartment of Medicine, The University of Adelaide, Adelaide, Australiaen_US
dc.identifier.affiliationSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australiaen_US
dc.identifier.affiliationDepartment of Nephrology, Princess Alexandra Hospital, Brisbane, Australiaen_US
dc.identifier.affiliationAustralasian Kidney Trials Network, The University of Queensland, Brisbane, Australiaen_US
dc.identifier.affiliationDepartment of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealanden_US
dc.identifier.affiliationDepartment of Renal Medicine, Auckland District Health Board, Auckland City Hospital, Auckland, New Zealanden_US
dc.identifier.affiliationAustralia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australiaen_US
dc.identifier.affiliationDepartment of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australiaen_US
dc.identifier.affiliationGeneral Medicineen_US
dc.identifier.affiliationCentral and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australiaen_US
dc.identifier.affiliationCharles Perkins Centre, The University of Sydney, Sydney, Australiaen_US
dc.identifier.affiliationDepartment of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealanden_US
dc.type.austinJournal Article-, Peter F
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.languageiso639-1en- for Breathing and Sleep- (University of Melbourne)-
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