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.