Anesthesia Type Impacts Ferroptosis, Humanin, and MOTS-c Levels in Renal Transplant Recipients

Patients with end-stage renal disease rely on renal transplantation as the most effective replacement therapy. However, ischemia-reperfusion injury (IRI) frequently compromises graft function and long-term outcomes. Recent research highlights ferroptosis as a key mechanism in IRI pathogenesis. Conversely, mitochondrial-derived peptides humanin and MOTS-c are recognized for their protective roles against oxidative stress. The critical knowledge gap lies in understanding how different anesthetic techniques influence these crucial biomarkers in kidney transplant recipients, a factor potentially impacting post-transplant recovery and graft viability.

This prospective controlled study will enroll adult kidney transplant recipients to compare the effects of two anesthetic approaches: sevoflurane general anesthesia (SGA) and combined spinal-epidural anesthesia (CSEA). Blood samples will be collected perioperatively from all participants. These samples will then undergo analysis to determine serum levels of various ferroptosis markers, as well as the mitochondrial-derived peptides humanin and MOTS-c. The study design aims to isolate the influence of the anesthetic technique on these specific biomarkers, providing insights into their modulation during renal transplantation.

This abstract describes a study protocol, and as such, no results or specific findings are available yet. The primary objective is to evaluate the effects of the chosen anesthetic technique on serum levels of ferroptosis markers, humanin, and MOTS-c. Secondary objectives include assessing early graft function and postoperative outcomes, such as the incidence of delayed graft function, postoperative serum creatinine levels, requirement for dialysis, urine output, and length of hospital stay. The study also aims to explore the association of these clinical outcomes with the perioperative biomarker levels. Without actual data, no numerical results, p-values, or fold-changes can be reported at this stage. The study's design is focused on generating these critical data points to inform future clinical practice.