Simple device improves care after kidney transplantation

Summer 2021

For patients with end-stage renal disease, kidney transplantation can greatly improve their quality of life and can mean the difference between life and death. But many patients experience complications after surgery that can affect their recovery.

Research teams at Lawson Health Research Institute – the research institute of London Health Sciences Centre (LHSC) – are testing ways to improve outcomes for patients who have received a kidney transplant.

“After surgery, many organ recipients require a long hospital stay due to delayed kidney function, infection, lack of mobility, or edema,” says Dr. Alp Sener, a scientist at Lawson and transplant surgeon in the Multi-Organ Transplant Program at LHSC.

Edema is swelling caused by excess fluid trapped in the body’s tissues which can impact wound healing. The standard of care for managing lower-limb edema and improving blood flow has been thrombo-embolic-deterrent (TED) stockings used with compression devices. Sleeves pumped with air squeeze the lower legs to boost circulation. They can be uncomfortable to wear, and the large pump can make it difficult for patients to move around or sleep after surgery.

A recently published study from Lawson showed that a simple device is more effective in reducing swelling after kidney transplantation. The geko™ device is a muscle pump activator which significantly improves blood flow, manufactured by Sky Medical Technology Ltd and distributed in Canada by Trudell Healthcare Solutions Inc. The small device is worn on the leg and generates pain-free muscle contractions. This causes the deep veins in the lower legs to compress, creating better blood flow in these vessels and returning blood to the heart.

As part of a randomized controlled clinical trial spanning two years, 221 transplant recipients at LHSC either wore the standard TED stocking or the geko™ device for six days after surgery.

Dr. Sener’s research team found that wearing the geko™ device increased urine output by 27 per cent and lowered weight gain by more than a kilogram. With more urine produced and less fluid retention, patients had 31 per cent less swelling. Those using the device also experienced less time in hospital, with hospitalization shortened by more than one day.

A 60 per cent reduction in wound infection rates was a striking observation made during the study.

“Transplant patients are at a higher risk of infection due to the immunosuppressant medications needed after surgery,” explains Dr. Sener. “Reducing infection means a much better outcome for the patient. Considering that recent data shows wound infections can cost the health-care system thousands of dollars per person, it’s a win-win situation.”

Some of the study participants wore pedometers to track their steps. Those using the geko™ device had improved mobility after surgery. The team suspects this may be due to reduced swelling, which could improve ease and comfort when moving.

“The study results have been both surprising and exciting. Not only have we cut down wound infection rates but we have also seen a considerable improvement in the new organ’s function following transplantation. Patients report feeling more satisfied with the transplant process and are more mobile,” remarks Dr. Sener.

He adds that the device is now being offered to kidney transplant patients at LHSC who are experiencing delayed kidney function, lack of mobility, or edema. “It could be a game changer for other procedures like orthopedic implants where wound infection can have disastrous consequences or in surgeries where wound infections are more common, such as cancer and intestinal surgery.”

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A surgical team examines the gekoTM device – a simple device that can reduce swelling after kidney transplantation.
The gekoTM device
Dr. Alp Sener