Transporting Live Donor Kidneys for Kidney Paired Donation: Initial National Results

被引:57
作者
Segev, D. L. [1 ,2 ]
Veale, J. L. [3 ]
Berger, J. C. [1 ]
Hiller, J. M. [1 ]
Hanto, R. L. [4 ]
Leeser, D. B. [5 ]
Geffner, S. R. [6 ]
Shenoy, S. [7 ]
Bry, W. I. [8 ]
Katznelson, S. [8 ]
Melcher, M. L. [9 ]
Rees, M. A. [10 ]
Samara, E. N. S. [11 ]
Israni, A. K. [12 ]
Cooper, M. [13 ]
Montgomery, R. J. [1 ]
Malinzak, L. [14 ]
Whiting, J. [15 ]
Baran, D. [16 ]
Tchervenkov, J. I. [16 ]
Roberts, J. P. [17 ]
Rogers, J. [18 ]
Axelrod, D. A. [19 ]
Simpkins, C. E. [1 ]
Montgomery, R. A. [1 ]
机构
[1] Johns Hopkins Univ, Dept Surg, Baltimore, MD 21218 USA
[2] Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD USA
[3] Univ Calif Los Angeles, Dept Urol, Los Angeles, CA USA
[4] New England Organ Bank Inc, New England Program Kidney Exchange, Newton, MA USA
[5] New York Presbyterian Hosp, Weill Cornell Med Coll, Dept Surg, New York, NY USA
[6] St Barnabas Hosp, Dept Surg, Livingston, NJ USA
[7] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA
[8] Calif Pacific Med Ctr, Dept Transplantat, San Francisco, CA USA
[9] Stanford Univ, Med Ctr, Dept Surg, Palo Alto, CA 94304 USA
[10] Univ Toledo, Med Ctr, Dept Urol, Toledo, OH 43606 USA
[11] Integris Baptist Med Ctr, Kidney Transplant Sect, Oklahoma City, OK USA
[12] Univ Minnesota, Hennepin Cty Med Ctr, Dept Med, Minneapolis, MN 55415 USA
[13] Univ Maryland, Sch Med, Dept Surg, Baltimore, MD 21201 USA
[14] Henry Ford Hosp, Henry Ford Transplant Inst, Detroit, MI 48202 USA
[15] Maine Med Ctr, Div Organ Transplantat, Portland, ME 04102 USA
[16] McGill Univ, Ctr Hosp, Montreal, PQ, Canada
[17] Univ Calif San Francisco, Dept Surg, San Francisco, CA 94143 USA
[18] Wake Forest Univ, Baptist Med Ctr, Dept Surg, Winston Salem, NC 27109 USA
[19] Dartmouth Hitchcock Med Ctr, Dept Surg, Lebanon, NH 03766 USA
关键词
Desensitization; incompatible kidney transplantation; IVIG; plasmapheresis; TRANSPLANTATION; EXCHANGE; OUTCOMES; CHAIN;
D O I
10.1111/j.1600-6143.2010.03386.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Optimizing the possibilities for kidney-paired donation (KPD) requires the participation of donor-recipient pairs from wide geographic regions. Initially it was envisaged that donors would travel to the recipient center; however, to minimize barriers to participation and simplify logistics, recent trends have involved transporting the kidneys rather than the donors. The goal of this study was to review outcomes of this practice. KPD programs throughout the United States were directly queried about all transplants involving live donor kidney transport. Early graft function was assessed by urine output in the first 8 h, postoperative serum creatinine trend, and incidence of delayed graft function. Between April 27, 2007 and April 29, 2010, 56 live donor kidneys were transported among 30 transplant centers. Median CIT was 7.2 h (IQR 5.5-9.7, range 2.5-14.5). Early urine output was robust (> 100 cc/h) in all but four patients. Creatinine nadir was < 2.0 mg/dL in all (including the four with lower urine output) but one patient, occurring at a median of 3 days (IQR 2-5, range 1-49). No patients experienced delayed graft function as defined by the need for dialysis in the first week. Current evidence suggests that live donor kidney transport is safe and feasible.
引用
收藏
页码:356 / 360
页数:5
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