Hypothermic machine perfusion results in a marginal kidney transplant programme

Background: Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results. Objective:...

Descripción completa

Detalles Bibliográficos
Autores: Gómez Dos Santos, María Victoria|||0000-0003-2968-148X, Ruiz Hernández, Mercedes, Burgos Revilla, Francisco Javier|||0000-0002-0758-5414
Tipo de recurso: artículo
Fecha de publicación:2018
País:España
Institución:Universidad de Alcalá (UAH)
Repositorio:e_Buah Biblioteca Digital Universidad de Alcalá
Idioma:inglés
OAI Identifier:oai:ebuah.uah.es:10017/67935
Acceso en línea:http://hdl.handle.net/10017/67935
https://dx.doi.org/10.1016/j.euf.2018.05.011
Access Level:acceso abierto
Palabra clave:Kidney transplantation
Organ preservation
Hypothermic machine perfusion
Brain death donor
Expanded criteria donor
Donor after circulatory death
Delayed graft function
Medicina
Medicine
id ES_564e39da9ea87e2efb7cf1da0bd6ae3b
oai_identifier_str oai:ebuah.uah.es:10017/67935
network_acronym_str ES
network_name_str España
repository_id_str
spelling Hypothermic machine perfusion results in a marginal kidney transplant programmeGómez Dos Santos, María Victoria|||0000-0003-2968-148XRuiz Hernández, MercedesBurgos Revilla, Francisco Javier|||0000-0002-0758-5414Kidney transplantationOrgan preservationHypothermic machine perfusionBrain death donorExpanded criteria donorDonor after circulatory deathDelayed graft functionMedicinaMedicineBackground: Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results. Objective: To identify factors impacting HMP in transplantation from marginal donors. Design, setting, and participants: Analysis of prospectively collected cohort data of expanded criteria donor (ECD) and donor after circulatory death (DCD) categories II and III was performed. A total of 214 adult recipients of first kidney transplantation with complete data and a minimum of 6-mo follow-up were included. Outcome measurements and statistical analysis: Delayed graft function (DGF) was defined as the lack of decrease in creatinine level in the first 48 h. Graft loss was defined as return to dialysis or creatinine clearance <15 ml/min/1.73 m2. Univariate and multivariate logistic regression analyses for DGF were constructed to identify independent risk factors. Recipient and graft survival (GS) analyses were conducted by Kaplan-Meier, and univariate and multivariate Cox regression analyses. Results and limitation: DGF occurred in 32.8% of imported and 20.5% of local grafts (p = 0.059). Only donor category (DCD; odds ratio [OR]: 6.6, p = 0.008) and haemodialysis (OR: 3.5, p = 0.002) were significantly associated with DGF development. The 1-yr GS rate was 92.5% in the local donor group and 84.3% in the imported donor group (p = 0.050). Multivariate analysis by Cox proportional hazards model identified only donor category (hazard ratio [HR] 10.99, p = 0.001) and donor age (HR 1.07, p = 0.005) as predictive variables for GS. The small sample size of the DCD group diminished the statistical power and did not permit a subgroup analysis to determine the impact of specific DCD category on HMP results. Conclusions: DCD donor category, but not donor centre of origin, impacted DGF development and GS in the HMP of deceased donor kidneys. Patient summary: Currently, the number of donors is insufficient to meet the demand for renal grafts. Expanded criteria for donation after brain death and donation after circulatory death (DCD) programmes have been developed as strategies to minimise this problem. Hypothermic machine perfusion has previously demonstrated its usefulness in expanded criteria donation and DCD preservation. DCD type and donor age increase the risk of graft loss.20182018-03-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10017/67935https://dx.doi.org/10.1016/j.euf.2018.05.01129929872reponame:e_Buah Biblioteca Digital Universidad de Alcaláinstname:Universidad de Alcalá (UAH)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ebuah.uah.es:10017/679352026-06-18T11:13:07Z
dc.title.none.fl_str_mv Hypothermic machine perfusion results in a marginal kidney transplant programme
title Hypothermic machine perfusion results in a marginal kidney transplant programme
spellingShingle Hypothermic machine perfusion results in a marginal kidney transplant programme
Gómez Dos Santos, María Victoria|||0000-0003-2968-148X
Kidney transplantation
Organ preservation
Hypothermic machine perfusion
Brain death donor
Expanded criteria donor
Donor after circulatory death
Delayed graft function
Medicina
Medicine
title_short Hypothermic machine perfusion results in a marginal kidney transplant programme
title_full Hypothermic machine perfusion results in a marginal kidney transplant programme
title_fullStr Hypothermic machine perfusion results in a marginal kidney transplant programme
title_full_unstemmed Hypothermic machine perfusion results in a marginal kidney transplant programme
title_sort Hypothermic machine perfusion results in a marginal kidney transplant programme
dc.creator.none.fl_str_mv Gómez Dos Santos, María Victoria|||0000-0003-2968-148X
Ruiz Hernández, Mercedes
Burgos Revilla, Francisco Javier|||0000-0002-0758-5414
author Gómez Dos Santos, María Victoria|||0000-0003-2968-148X
author_facet Gómez Dos Santos, María Victoria|||0000-0003-2968-148X
Ruiz Hernández, Mercedes
Burgos Revilla, Francisco Javier|||0000-0002-0758-5414
author_role author
author2 Ruiz Hernández, Mercedes
Burgos Revilla, Francisco Javier|||0000-0002-0758-5414
author2_role author
author
dc.subject.none.fl_str_mv Kidney transplantation
Organ preservation
Hypothermic machine perfusion
Brain death donor
Expanded criteria donor
Donor after circulatory death
Delayed graft function
Medicina
Medicine
topic Kidney transplantation
Organ preservation
Hypothermic machine perfusion
Brain death donor
Expanded criteria donor
Donor after circulatory death
Delayed graft function
Medicina
Medicine
description Background: Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results. Objective: To identify factors impacting HMP in transplantation from marginal donors. Design, setting, and participants: Analysis of prospectively collected cohort data of expanded criteria donor (ECD) and donor after circulatory death (DCD) categories II and III was performed. A total of 214 adult recipients of first kidney transplantation with complete data and a minimum of 6-mo follow-up were included. Outcome measurements and statistical analysis: Delayed graft function (DGF) was defined as the lack of decrease in creatinine level in the first 48 h. Graft loss was defined as return to dialysis or creatinine clearance <15 ml/min/1.73 m2. Univariate and multivariate logistic regression analyses for DGF were constructed to identify independent risk factors. Recipient and graft survival (GS) analyses were conducted by Kaplan-Meier, and univariate and multivariate Cox regression analyses. Results and limitation: DGF occurred in 32.8% of imported and 20.5% of local grafts (p = 0.059). Only donor category (DCD; odds ratio [OR]: 6.6, p = 0.008) and haemodialysis (OR: 3.5, p = 0.002) were significantly associated with DGF development. The 1-yr GS rate was 92.5% in the local donor group and 84.3% in the imported donor group (p = 0.050). Multivariate analysis by Cox proportional hazards model identified only donor category (hazard ratio [HR] 10.99, p = 0.001) and donor age (HR 1.07, p = 0.005) as predictive variables for GS. The small sample size of the DCD group diminished the statistical power and did not permit a subgroup analysis to determine the impact of specific DCD category on HMP results. Conclusions: DCD donor category, but not donor centre of origin, impacted DGF development and GS in the HMP of deceased donor kidneys. Patient summary: Currently, the number of donors is insufficient to meet the demand for renal grafts. Expanded criteria for donation after brain death and donation after circulatory death (DCD) programmes have been developed as strategies to minimise this problem. Hypothermic machine perfusion has previously demonstrated its usefulness in expanded criteria donation and DCD preservation. DCD type and donor age increase the risk of graft loss.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018-03-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10017/67935
https://dx.doi.org/10.1016/j.euf.2018.05.011
29929872
url http://hdl.handle.net/10017/67935
https://dx.doi.org/10.1016/j.euf.2018.05.011
identifier_str_mv 29929872
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:e_Buah Biblioteca Digital Universidad de Alcalá
instname:Universidad de Alcalá (UAH)
instname_str Universidad de Alcalá (UAH)
reponame_str e_Buah Biblioteca Digital Universidad de Alcalá
collection e_Buah Biblioteca Digital Universidad de Alcalá
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869408370092408832
score 15,811543

Similares en LA Referencia