In a published study, a team from Lawson Health Research Institute (LHSC), in Ontario Canada, has found that a simple medical device can reduce swelling after kidney transplantation.
The wearable geko device, manufactured by UK-based Sky Medical Technology and distributed in Canada by Trudell Healthcare Solutions, is a small muscle pump activator that significantly increases blood flow via painless electrical pulses. Patients using the device following kidney transplantation experienced shorter hospital stays and reduced surgical site infections by nearly 60%.
Kidney and simultaneous pancreas-kidney transplantations can significantly reduce mortality and improve the quality of life for patients with end stage renal disease.
Dr. Alp Sener, Lawson scientist and transplant surgeon in the Multi-Organ Transplant Program at LHSC, who led the study, said: “After surgery, many of these organ recipients require a longer hospital stay due to delayed kidney function, infection, lack of mobility or oedema.”
Oedema is swelling caused by excess fluid trapped in the body’s tissues which can impact wound healing. The current standard of care for managing lower-limb oedema and improving blood flow in Canada healthcare systems recommend thrombo-embolic-deterrent (TED) stockings, used alongside a boot-like cuff that compresses the leg to increase blood flow, called intermittent pneumatic compression (IPC). Both can be uncomfortable to wear, and IPC can inhibit early mobility and disrupt sleep after surgery.
In a randomised controlled clinical trial spanning two years, 221 transplant recipients at LHSC were prescribed either TED stocking and IPC, or the geko device for six days after surgery. The research team found that wearing the device increased urine output by 27% and lowered weight gain by over a kilogram. With more urine produced and less fluid retention, patients experienced 31% less swelling and the duration of costly hospitalisation was shortened by more than one day after kidney transplantation, compared to the standard of care.
A 60% reduction in wound infection rates was a striking observation.
Dr Sener added: “Transplant patients are at a higher risk of infection due to the immunosuppressant medications needed after surgery. Reducing infection means a much better outcome for the patient and 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, and those using the geko device also had improved mobility after surgery. The team suspects this may be due to reduced swelling which could improve ease and comfort when moving.
Dr Sener said: “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 reported feeling more satisfied with the transplant process and are more mobile.”
The geko device has been adopted into the care pathway and is now being offered to patients at LHSC in recovery after receiving a new kidney.
Ruben Garcia, 68, recently received a new kidney from his daughter, Ruby, who was a match as a living kidney donor. Following his surgery, Garcia found it difficult to get out of bed due to the pain and swelling, and the function of his new kidney was very low.
Dr. Sener recommended that Garcia use the geko device to help stimulate blood flow in a way that is similar to walking. Garcia was soon able to sit up on a chair and by the next day he was walking.
Garcia said: “My kidney woke up and started working again! I could feel the device working and it was comfortable to wear, almost like a massage for my legs. I’m very grateful for the care that I received.”
Dr. Sener added: “Using a muscle pump activator, like the geko device, could be a game changer for other procedures like orthopaedic implants, where wound infection can have disastrous consequences, or in surgeries where wound infections are more common, such as in cancer and intestinal surgery.”
The geko device is non-invasive, self-adhering, battery-powered and recyclable. It generates neuromuscular electro-stimulation and unparalleled systemic blood flow that equates to 60% of that achieved by walking. Pain-free muscle contraction compresses deep veins in the lower legs to create increased blood flow in these vessels and return blood to the heart.
George Baran, director of Sky Medical Technology, concludes: “The results of the study provide further evidence that the geko device is an effective treatment option that can improve outcomes for patients and help them return home sooner, while reducing costs for healthcare systems.”
