Results of kidney transplantation from controlled donors after cardio-circulatory death: a single center experience

被引:26
作者
Ledinh, Hieu [1 ]
Weekers, Laurent [2 ]
Bonvoisin, Catherine [2 ]
Krzesinski, Jean-Marie [2 ]
Monard, Josee [1 ]
de Roover, Arnaud [1 ]
Squifflet, Jean Paul [1 ]
Meurisse, Michel [1 ]
Detry, Olivier [1 ]
机构
[1] Univ Liege, Univ Hosp Liege, Dept Abdominal Surg & Transplantat, B-4000 Liege, Belgium
[2] Univ Liege, Univ Hosp Liege, Dept Nephrol, B-4000 Liege, Belgium
关键词
brain death; organ preservation; primary graft dysfunction; risk assessment; treatment outcome; warm ischemia; DELAYED GRAFT FUNCTION; DATA FOLLOW-UP; CARDIAC DEATH; RENAL-TRANSPLANTATION; MACHINE PERFUSION; COLD-STORAGE; BELGIAN DONOR; SURVIVAL; DONATION; LONG;
D O I
10.1111/j.1432-2277.2011.01402.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
The aim of this study was to determine results of kidney transplantation (KT) from controlled donation after cardio-circulatory death (DCD). Primary end-points were graft and patient survival, and post-transplant complications. The influence of delayed graft function (DGF) on graft survival and DGF risk factors were analyzed as secondary end-points. This is a retrospective mono-center review of a consecutive series of 59 DCD-KT performed between 2005 and 2010. Overall graft survival was 96.6%, 94.6%, and 90.7% at 3 months, 1 and 3 years, respectively. Main cause of graft loss was patients death with a functioning graft. No primary nonfunction grafts. Renal graft function was suboptimal at hospital discharge, but nearly normalized at 3 months. DGF was observed in 45.6% of all DCD-KT. DGF significantly increased postoperative length of hospitalization, but had no deleterious impact on graft function or survival. Donor body mass index =30 was the only donor factor that was found to significantly increase the risk of DGF (P < 0.05). Despite a higher rate of DGF, controlled DCD-KT offers a valuable contribution to the pool of deceased donor kidney grafts, with comparable mid-term results to those procured after brain death.
引用
收藏
页码:201 / 209
页数:9
相关论文
共 45 条
[1]   Early results of a controlled non-heart-beating kidney donor programme [J].
Akoh, Jacob A. ;
Denton, Mark D. ;
Bradshaw, Sharon B. ;
Rana, Tahawar A. ;
Walker, Martin B. .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2009, 24 (06) :1992-1996
[2]   Case-matched comparison of long-term results of non-heart beating and heart-beating donor renal transplants [J].
Barlow, A. D. ;
Metcalfe, M. S. ;
Johari, Y. ;
Elwell, R. ;
Veitch, P. S. ;
Nicholson, M. L. .
BRITISH JOURNAL OF SURGERY, 2009, 96 (06) :685-691
[3]   Report of a national conference on donation after cardiac death [J].
Bernat, JL ;
D'Alessandro, AM ;
Port, FK ;
Bleck, TP ;
Heard, SO ;
Medina, J ;
Rosenbaum, SH ;
DeVita, MA ;
Gaston, RS ;
Merion, RM ;
Barr, ML ;
Marks, WH ;
Nathan, H ;
O'Connor, K ;
Rudow, DL ;
Leichtman, AB ;
Schwab, P ;
Ascher, NL ;
Metzger, RA ;
Mc Bride, V ;
Graham, W ;
Wagner, D ;
Warren, J ;
Delmonico, FL .
AMERICAN JOURNAL OF TRANSPLANTATION, 2006, 6 (02) :281-291
[4]   Kidney transplantation from non heart-beating donors [J].
Brook, N ;
Nicholson, ML .
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND, 2003, 1 (06) :311-322
[5]   A report on the activity and clinical outcomes of renal non-heart beating donor transplantation in the United Kingdom [J].
Brook, NR ;
Waller, JR ;
Richardson, AC ;
Bradley, JA ;
Andrews, PA ;
Koffman, G ;
Gok, M ;
Talbot, D ;
Nicholson, ML .
CLINICAL TRANSPLANTATION, 2004, 18 (06) :627-633
[6]   Non-heart beating donor kidneys with delayed graft function have superior graft survival compared with conventional heart-beating donor kidneys that develop delayed graft function [J].
Brook, NR ;
White, SA ;
Waller, JR ;
Veitch, PS ;
Nicholson, ML .
AMERICAN JOURNAL OF TRANSPLANTATION, 2003, 3 (05) :614-618
[7]   Follow-up after renal transplantation with organs from donors after cardiac death [J].
Chapman, Jeremy ;
Bock, Andreas ;
Dussol, Bertrand ;
Fritsche, Lutz ;
Kliem, Volker ;
Lebranchu, Yvon ;
Oppenheimer, Federico ;
Pohanka, Erich ;
Salvadori, Maurizio ;
Tufveson, Gunnar .
TRANSPLANT INTERNATIONAL, 2006, 19 (09) :715-719
[8]   Successful DCD Kidney Transplantation Using Early Corticosteroid Withdrawal [J].
Chudzinski, R. E. ;
Khwaja, K. ;
Teune, P. ;
Miller, J. ;
Tang, H. ;
Pavlakis, M. ;
Rogers, C. ;
Johnson, S. ;
Karp, S. ;
Hanto, D. ;
Mandelbrot, D. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2010, 10 (01) :115-123
[9]   Expanding the donor pool to increase renal transplantation [J].
Cohen, B ;
Smits, JM ;
Haase, B ;
Persijn, G ;
Vanrenterghem, Y ;
Frei, U .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2005, 20 (01) :34-41
[10]  
D'Alessandro Anthony M, 2004, Ann Transplant, V9, P68