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A trial examining if less fluid administration is better than standard fluid administration in children undergoing kidney transplant

This study, called LIMITS, is for children having a kidney transplant. Doctors don't yet know the best amount of fluid to give during and after the operation. Too little could harm the new kidney, but too much can cause problems like breathing difficulties, swelling, and headaches. This study aims to find out if giving a limited amount of fluid, based on a child's size, leads to better outcomes than the usual larger amounts. We hope this will help children recover quicker, spend more time at home, and improve their overall experience after transplant. Teams of doctors, nurses, researchers, parents, and young people are working together on this important research.

At a glance

Status
Recruiting
Sponsor
Great Ormond Street Hospital for Children NHS Foundation Trust
Enrolment target
140
Start
23 Oct 2025
Estimated completion
30 Jun 2027

What is this study about?

When a child has a kidney transplant, they receive fluids through a drip during and after their operation. At the moment, doctors aren't sure of the exact best amount of fluid to give. Giving too little fluid might mean the new kidney takes longer to start working properly, or it could even lead to blood clots. However, too much fluid can also cause problems such as breathing difficulties, swelling, headaches, or high blood pressure.

These problems are important not only for the child's health but also require extra care from the NHS. The LIMITS study is a research project aiming to find the best balance. A team including kidney doctors, surgeons, a psychologist, parents, young people, and trial experts are working together to find answers. We want to see if children should receive a limited amount of fluid based on their body size, or if the larger amounts usually given are better.

This study hopes to improve how children recover after a kidney transplant. By finding the right amount of fluid, we could help children get better faster, have a better experience of their transplant, and potentially spend more time recovering at home instead of in hospital. The findings could change how doctors give fluids to children with new kidneys across the UK, making a real difference to their health and well-being.

Key takeaways

  • A study to find the best amount of fluid for children having kidney transplants.
  • Compares usual fluid amounts with a smaller, body-size-adjusted amount.
  • Aims to help children recover faster and spend more time at home.
  • No extra tests or hospital visits for children taking part.
  • Potential benefits include fewer side effects and quicker recovery.
  • Risks are not expected to be greater than standard care for a kidney transplant.

Who may be eligible?

This study is looking for children and young people who are having a kidney transplant in one of the UK hospitals taking part. This means they can be receiving a kidney from either a living donor (someone they know) or a deceased donor (someone who has passed away).

You must be under 18 years old when you have your kidney transplant to be able to join the study.

However, if you are having a transplant of other organs at the same time as your kidney, you won't be able to join this particular study.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

  1. Is your child having a kidney transplant in the UK?
  2. Is your child under 18 years old at the time of the transplant?
  3. Is your child only having a kidney transplant (not other organs too)?
  4. Will the transplant be from a living or deceased donor?
Answer every question to see your result.

What does participation involve?

If you decide to take part, the study will compare how children recover when they receive different amounts of fluid after their kidney transplant. Some children will get the larger amount of fluid that is usually given, while others will get a limited amount based on their body size. A completely fair and independent process will decide which group your child is in.

The fluids will be given through a drip into a vein, or through a feeding tube if your child already has one, or by mouth if that's their usual way. All children having this type of operation already receive fluids, so this part of the study won't add any extra procedures. Your child won't need any extra blood tests just for the study, and they won't have any extra hospital visits beyond their normal check-ups.

If blood tests are needed as part of their usual care, options for numbing cream (mild topical anaesthetics) and distraction techniques will be available to make it more comfortable. We will mostly be looking at how quickly children can go home after their transplant to see how well they are recovering. We will also ask children and parents about their symptoms and how they found their hospital stay.

Potential risks and benefits

Potential benefits of taking part could include experiencing fewer uncomfortable symptoms often linked to too much fluid, like swelling, breathlessness, headaches, or even fits. This might also mean fewer extra procedures or medications to treat these issues, which could be distressing. There's also a chance that children in the study might be able to go home sooner after their transplant. We believe there are very few extra risks to taking part in this study beyond the usual risks of having a kidney transplant itself. The main risks of the standard treatment (giving a lot of fluid) include high blood pressure, fluid in the lungs (which can make breathing hard), and changes in body salts that could cause fits. However, your child will be watched very closely throughout the study, and if any problems come up, they will be treated quickly, just as they would be in standard care. You can also withdraw from the study at any time.

Locations (13)

  • Great Ormond Street Hospital for Children
    Approximate
    London, England
  • Evelina London Children's Hospital
    Approximate
    London, England
  • Bristol Royal Hospital for Children
    Approximate
    Bristol, England
  • Birmingham Childrens Hospital
    Approximate
    Birmingham, England
  • Royal Manchester Childrens Hospital
    City only
    Manchester, England
  • Leeds Children's Hopsital
    City only
    Leeds, England
  • Royal Hospital for Sick Children (Glasgow)
    Approximate
    Glasgow, Scotland
  • Great North Children's Hopsital
    City only
    Newcastle upon Tyne, England
  • Nottingham Children's Hospital
    City only
    Nottingham, England
  • The Royal Belfast Hospital for Sick Children
    City only
    Belfast, Northern Ireland
  • University Hospital of Wales
    Unverified
    Cardiff, Wales
  • University Hospital Southampton NHS Foundation Trust
    Unverified
    Southampton, England

Common questions

What is the main goal of this study?

The main goal is to find out the best amount of fluid to give children after a kidney transplant to help them recover faster and have fewer complications.

How will you decide which amount of fluid my child gets?

An independent process will randomly decide if your child receives the usual amount of fluid or a limited amount based on their body size. This is like flipping a coin to make it fair.

Will my child have extra tests or hospital visits if they join?

No, your child will not have any extra blood tests just for the study, and no extra hospital visits beyond their routine check-ups after the transplant.

What are the possible benefits for my child?

Possible benefits include fewer uncomfortable symptoms like swelling or headaches, and potentially going home earlier after their transplant.

Who is running and paying for this study?

The study is being run from Great Ormond Street Hospital for Children and is funded by the National Institute for Health and Care Research (NHS UK).

How to find out more

Fotini Kaloyirou

Always speak to your GP or specialist before deciding to take part in a study.

Discussion

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