Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival
| Autor: | M. Sevinc, S. Stamp, J. Ling, N. Carter, D. Talbot, N. Sheerin |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty 030232 urology & nephrology Ischemia Renal function 030230 surgery Kidney 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Kidney transplantation Glutathione Transferase Transplantation Machine perfusion business.industry Vascular disease Graft Survival Middle Aged medicine.disease Kidney Transplantation Tissue Donors Surgery Death Perfusion surgical procedures operative medicine.anatomical_structure Hypertension Cardiology Female business sub_biomedicalsciences |
| Zdroj: | Transplantation Proceedings. 48:3251-3260 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2016.09.049 |
| Popis: | Background Ex vivo perfusion is used in our unit for kidneys donated after cardiac death (DCD). Perfusion flow index (PFI), resistance, and perfusate glutathione S -transferase (GST) can be measured to assess graft viability. We assessed whether measurements taken during perfusion could predict long-term outcome after transplantation. Methods All DCD kidney transplants performed from 2002 to 2014 were included in this study. The exclusion criteria were: incomplete data, kidneys not machine perfused, kidneys perfused in continuous mode, and dual transplantation. There were 155 kidney transplantations included in the final analysis. Demographic data, ischemia times, donor hypertension, graft function, survival and machine perfusion parameters after 3 hours were analyzed. Each perfusion parameter was divided into 3 groups as high, medium, and low. Estimated glomerular filtration rate was calculated at 12 months and then yearly after transplantation. Results There was a significant association between graft survival and PFI and GST ( P values, .020 and .022, respectively). PFI was the only independent parameter to predict graft survival. Conclusions A low PFI during ex vivo hypothermic perfusion is associated with inferior graft survival after DCD kidney transplantation. We propose that PFI is a measure of the health of the graft vasculature and that a low PFI indicates vascular disease and therefore predicts a worse long-term outcome. |
| Databáze: | OpenAIRE |
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