Volatile anaesthetics and organ protection in kidney transplantation: finally, a randomized controlled trial!

Many clinical trials have evaluated whether volatile anaesthetics are protective in scenarios of ischaemia–reperfusion (I/R). Although the majority of studies of I/R injury involve cardiac surgery with cardiopulmonary bypass,¹² some have been performed in lung surgery with one-lung ventilation,³ liver resection under inflow occlusion,⁴ or liver transplantation.⁵ The study by Niewuwenhuijs-Moeke and colleagues⁶ in this issue of the BritishJournalof Anaesthesia is the first to evaluate direct effects of volatile anaesthetics on kidneys undergoing I/R injury during transplantation (volatile anaesthetic protection of renal transplants, VAPOR-1 trial). The authors are to be congratulated for their efforts. So far, only animal experiments have addressed the impact of volatile anaesthetics on renal I/R injury, or the kidneys were evaluated only as a secondary outcome in clinical trials.² Therefore, this study increases our knowledge and experience of organ protection and volatile anaesthetics.

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