Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study

INTRODUCTION: Many European countries have transplant programmes with controlled donors after cardiac death (cDCD). Twenty-two centres are part of GEODAS group. We analysed clinical results from a nephrological perspective. METHODS: Observational, retrospective and multicentre study with systematic...

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Autores: Portolés, José, Pérez-Sáez, María José, Pascual Santos, Julio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/41795
Acceso en línea:http://hdl.handle.net/10230/41795
http://dx.doi.org/10.1016/j.nefro.2018.07.013
Access Level:acceso abierto
Palabra clave:Clinical outcomes
Delayed graft function
Donación tras parada circulatoria controlada
Donation with controlled donors after circulatory death
Función retrasada del injerto
Kidney transplant
Resultados clínicos
Trasplante renal
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spelling Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre studyPortolés, JoséPérez-Sáez, María JoséPascual Santos, JulioClinical outcomesDelayed graft functionDonación tras parada circulatoria controladaDonation with controlled donors after circulatory deathFunción retrasada del injertoKidney transplantResultados clínicosTrasplante renalINTRODUCTION: Many European countries have transplant programmes with controlled donors after cardiac death (cDCD). Twenty-two centres are part of GEODAS group. We analysed clinical results from a nephrological perspective. METHODS: Observational, retrospective and multicentre study with systematic inclusion of all kidney transplant recipients from cDCD, following local protocols regarding extraction and immunosuppression. RESULTS: A total of 335 cDCD donors (mean age 57.2 years) whose deaths were mainly due to cardiovascular events were included. Finally, 566 recipients (mean age 56.5 years; 91.9% first kidney transplant) were analysed with a median of follow-up of 1.9 years. Induction therapy was almost universal (thymoglobulin 67.4%; simulect 32.8%) with maintenance with prednisone-MMF-tacrolimus (91.3%) or combinations with mTOR (6.5%). Mean cold ischaemia time (CIT) was 12.3h. Approximately 3.4% (n=19) of recipients experienced primary non-function, essentially associated with CIT (only CIT ≥ 14 h was associated with primary non-function). Delayed graft function (DGF) was 48.8%. DGF risk factors were CIT ≥ 14 h OR 1.6, previous haemodialysis (vs. peritoneal dialysis) OR 2.1 and donor age OR 1.01 (per year). Twenty-one patients (3.7%) died with a functioning graft, with a recipient and death-censored graft survival at 2-years of 95% and 95.1%, respectively. The estimated glomerular filtration rate at one year of follow-up was 60.9 ml/min. CONCLUSIONS: CIT is a modifiable factor for improving the incidence of primary non-function in kidney transplant arising from cDCD. cDCD kidney transplant recipients have higher delayed graft function rate, but the same patient and graft survival compared to brain-dead donation in historical references. These results are convincing enough to continue fostering this type of donation.Elsevier201920192019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/41795http://dx.doi.org/10.1016/j.nefro.2018.07.013reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)Inglés2013-2514/© 2018 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/417952026-05-29T05:05:01Z
dc.title.none.fl_str_mv Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
title Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
spellingShingle Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
Portolés, José
Clinical outcomes
Delayed graft function
Donación tras parada circulatoria controlada
Donation with controlled donors after circulatory death
Función retrasada del injerto
Kidney transplant
Resultados clínicos
Trasplante renal
title_short Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
title_full Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
title_fullStr Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
title_full_unstemmed Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
title_sort Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
dc.creator.none.fl_str_mv Portolés, José
Pérez-Sáez, María José
Pascual Santos, Julio
author Portolés, José
author_facet Portolés, José
Pérez-Sáez, María José
Pascual Santos, Julio
author_role author
author2 Pérez-Sáez, María José
Pascual Santos, Julio
author2_role author
author
dc.subject.none.fl_str_mv Clinical outcomes
Delayed graft function
Donación tras parada circulatoria controlada
Donation with controlled donors after circulatory death
Función retrasada del injerto
Kidney transplant
Resultados clínicos
Trasplante renal
topic Clinical outcomes
Delayed graft function
Donación tras parada circulatoria controlada
Donation with controlled donors after circulatory death
Función retrasada del injerto
Kidney transplant
Resultados clínicos
Trasplante renal
description INTRODUCTION: Many European countries have transplant programmes with controlled donors after cardiac death (cDCD). Twenty-two centres are part of GEODAS group. We analysed clinical results from a nephrological perspective. METHODS: Observational, retrospective and multicentre study with systematic inclusion of all kidney transplant recipients from cDCD, following local protocols regarding extraction and immunosuppression. RESULTS: A total of 335 cDCD donors (mean age 57.2 years) whose deaths were mainly due to cardiovascular events were included. Finally, 566 recipients (mean age 56.5 years; 91.9% first kidney transplant) were analysed with a median of follow-up of 1.9 years. Induction therapy was almost universal (thymoglobulin 67.4%; simulect 32.8%) with maintenance with prednisone-MMF-tacrolimus (91.3%) or combinations with mTOR (6.5%). Mean cold ischaemia time (CIT) was 12.3h. Approximately 3.4% (n=19) of recipients experienced primary non-function, essentially associated with CIT (only CIT ≥ 14 h was associated with primary non-function). Delayed graft function (DGF) was 48.8%. DGF risk factors were CIT ≥ 14 h OR 1.6, previous haemodialysis (vs. peritoneal dialysis) OR 2.1 and donor age OR 1.01 (per year). Twenty-one patients (3.7%) died with a functioning graft, with a recipient and death-censored graft survival at 2-years of 95% and 95.1%, respectively. The estimated glomerular filtration rate at one year of follow-up was 60.9 ml/min. CONCLUSIONS: CIT is a modifiable factor for improving the incidence of primary non-function in kidney transplant arising from cDCD. cDCD kidney transplant recipients have higher delayed graft function rate, but the same patient and graft survival compared to brain-dead donation in historical references. These results are convincing enough to continue fostering this type of donation.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/41795
http://dx.doi.org/10.1016/j.nefro.2018.07.013
url http://hdl.handle.net/10230/41795
http://dx.doi.org/10.1016/j.nefro.2018.07.013
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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