No impact of disseminated intravascular coagulation in kidney donors on long-term kidney transplantation outcome: A multicenter propensity-matched study.

Autor: Garrouste C; Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France., Baudenon J; Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France., Gatault P; Department of Nephrology and Clinical Immunology, CHRU de Tours, Tours, France., Pereira B; Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, Clermont-Ferrand, France., Etienne I; Department of Nephrology, CHRU de Rouen, Rouen, France., Thierry A; Department of Nephrology Dialysis and Kidney Transplantation, CHU de Poitiers, Poitiers, France., Szlavik N; Pathology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France., Aniort J; Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France., Rabant M; Pathology Department, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France., Lambert C; Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, Clermont-Ferrand, France., Sayegh J; Department of Nephrology Dialysis and Kidney Transplantation, CHU d' Angers, Angers, France., Oniszczuk J; Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France., Anglicheau D; Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France., Heng AE; Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2019 Feb; Vol. 19 (2), pp. 448-456. Date of Electronic Publication: 2018 Aug 23.
DOI: 10.1111/ajt.15008
Abstrakt: The diagnosis of disseminated intravascular coagulation (DIC) is often considered to be a contraindication to organ donation. The aim of this study was to evaluate the impact of DIC+ donors on kidney recipient (KR) evolution. We identified 169 KRs with DIC+ donation after brain death donors between January 1996 and December 2012 in 6 French transplant centers. Individuals were matched using propensity scores to 338 recipients with DIC- donors according to donor age and sex, whether expanded criteria for the donor existed, graft year, and transplantation center. After kidney transplantation, delayed graft function was observed in 28.1% of DIC+ KRs and in 22.8% of DIC- KRs (NS). Renal allograft survival at 1, 5, and 10 years was 94.5%, 89.3%, and 73.9% and 96.2%, 90.8%, and 81.3% in DIC+ KRs and DIC- KRs, respectively (NS). The median estimated glomerular filtration rate (eGFR) was similar between DIC+ and DIC- KRs at 3 months, 1 year, and 10 years: 45.9 vs 48.1 mL/min, 42.1 vs 43.1 mL/min, and 33.9 vs 38.1 mL/min, respectively. Delayed calcineurin inhibitor introduction or induction had no impact on delayed graft function rate or eGFR evolution at 10 years after transplantation in DIC+ KRs. Donor DIC did not seem to affect initial outcome, long-term graft function, or allograft survival.
(© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
Externí odkaz: