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
[11]   Short- and long-term outcomes with the use of kidneys and livers donated after cardiac death [J].
Doshi, M. D. ;
Hunsicker, L. G. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2007, 7 (01) :122-129
[12]   Long-term results of renal transplantation using kidneys harvested from non-heartbeating donors:: A 15-year experience [J].
Droupy, S ;
Blanchet, P ;
Eschwège, P ;
Hammoudi, Y ;
Joseph, L ;
Kriaa, F ;
Bedossa, P ;
Duranteau, J ;
Charpentier, B ;
Benoit, G .
JOURNAL OF UROLOGY, 2003, 169 (01) :28-31
[13]   The significance of subclinical rejection [J].
El-Amm, Jose-Marie ;
Gruber, Scott A. .
CLINICAL TRANSPLANTATION, 2009, 23 (02) :150-156
[14]   Plasma creatinine, Cockcroft and MDRD: validity and limitations for evaluation of renal function in chronic kidney disease [J].
Flamant, Martin ;
Boulanger, Henri ;
Azar, Hiba ;
Vrtovsnik, Francois .
PRESSE MEDICALE, 2010, 39 (03) :303-311
[15]  
Houillier Pascal, 2005, Rev Prat, V55, P91
[16]   Non-heart-beating donor kidneys in The Netherlands: Allocation and outcome of transplantation [J].
Keizer, KM ;
de Fifter, JW ;
Haase-Kromwijk, BJJM ;
Weimar, W .
TRANSPLANTATION, 2005, 79 (09) :1195-1199
[17]   Urological complications and their impact on survival after kidney transplantation from deceased cardiac death donors [J].
Khairoun, Meriem ;
Baranski, Andrzej G. ;
van der Boog, Paul J. M. ;
Haasnoot, Ada ;
Mallat, Marko J. K. ;
Marang-van de Mheen, Perla J. .
TRANSPLANT INTERNATIONAL, 2009, 22 (02) :192-197
[18]   Outcome of kidney transplantation from nonheart-beating versus heart-beating cadaveric donors [J].
Kokkinos, Constantinos ;
Antcliffe, David ;
Nanidis, Theodore ;
Darzi, Ara W. ;
Tekkis, Paris ;
Papalois, Vassilios .
TRANSPLANTATION, 2007, 83 (09) :1193-1199
[19]   The asystolic, or non-heartbeating, donor [J].
Kootstra, G .
TRANSPLANTATION, 1997, 63 (07) :917-921
[20]   Non-heartbeating donation of kidneys for transplantation [J].
Kootstra, Gauke ;
van Heurn, Ernest .
NATURE CLINICAL PRACTICE NEPHROLOGY, 2007, 3 (03) :154-163