Sequential transplant of paired kidneys following donation after cardiac death: impact of longer cold ischemia time on the second kidney on graft and patient outcome.

Autor: Goldsmith PJ; Department of Organ Transplantation, St James’s University Hospital, Leeds, United Kingdom. Goldsmithpaul@hotmail.com, Ridgway DM, Pine JK, Ecuyer C, Baker R, Newstead C, Hostert L, Pollard SG, Attia M, Menon KV, Ahmad N
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2010 Dec; Vol. 42 (10), pp. 3960-2.
DOI: 10.1016/j.transproceed.2010.09.135
Abstrakt: The United Kingdom has no national sharing scheme for kidneys received from donation after cardiac death (DCD). Therefore, both kidneys retrieved by a transplant team are implanted at a single unit, often sequentially. This study analyzes the impact of a prolonged cold ischaemia time on the second transplanted kidney and the effects on short-term and long-term outcomes in all our DCD renal implants from 2002 to 2009. Cold ischaemia time was significantly longer with the second kidney (P = .04) as was delayed graft function (P = .02). Acute rejection was increased in the first transplanted kidney (P < .001). Five-year patient survival was comparable between groups, but 5-year graft survival was higher in the second transplanted group (P = .04). The results confirm that, provided recipient centers are willing to accept higher initial rates of delayed graft function, it is acceptable to transplant DCD grafts sequentially without jeopardizing long-term graft or recipient outcome.
(Copyright © 2010 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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