BACKGROUND: Warm ischemia time and ischemia-reperfusion damage result in higher rates of delayed graft function and primary nonfunction in kidney transplants (KTs) from controlled donation after circulatory death (cDCD). This study aimed to assess early and late kidney function and patient and graft survival of KT from cDCD preserved with normothermic regional perfusion (NRP) and to compare with KT from brain death donors (DBDs) and cDCD preserved with rapid recovery (RR). METHODS: Patients who received a KT at our institution from 2012 to 2018 were included, with a minimum follow-up period of 1 y. They were categorized by donor type and conditioning methods: DBD, cDCD with NRP, and cDCD with RR. Early and late graft function, along with patient and graft survival were analyzed in all groups. RESULTS: A total of 182 KT recipients were included in the study (98 DBD and 84 cDCD). Out of the cDCDs, 24 kidneys were recovered with the use of NRP and 62 with RR; 22 of the 24 kidneys were ultimately transplanted. The cDCD using NRP group showed lower rates of delayed graft function compared with the cDCD with RR group (36.3% versus 46.7%, P = 0.01). Also, primary nonfunction rates were lower in the cDCD using NRP group (4.5% versus 6.4% cDCD-RR and 10.2% DBD). Patient survival rates were >90% in all groups. No differences were found in graft survival rates at 1 y. CONCLUSIONS: The use of abdominal NRP improves early function recovery of KT from cDCD, making their outcomes comparable with those of DBD.
BACKGROUND: Warm ischemia time and ischemia-reperfusion damage result in higher rates of delayed graft function and primary nonfunction in kidney transplants (KTs) from controlled donation after circulatory death (cDCD). This study aimed to assess early and late kidney function and patient and graft survival of KT from cDCD preserved with normothermic regional perfusion (NRP) and to compare with KT from brain death donors (DBDs) and cDCD preserved with rapid recovery (RR). METHODS: Patients who received a KT at our institution from 2012 to 2018 were included, with a minimum follow-up period of 1 y. They were categorized by donor type and conditioning methods: DBD, cDCD with NRP, and cDCD with RR. Early and late graft function, along with patient and graft survival were analyzed in all groups. RESULTS: A total of 182 KT recipients were included in the study (98 DBD and 84 cDCD). Out of the cDCDs, 24 kidneys were recovered with the use of NRP and 62 with RR; 22 of the 24 kidneys were ultimately transplanted. The cDCD using NRP group showed lower rates of delayed graft function compared with the cDCD with RR group (36.3% versus 46.7%, P = 0.01). Also, primary nonfunction rates were lower in the cDCD using NRP group (4.5% versus 6.4% cDCD-RR and 10.2% DBD). Patient survival rates were >90% in all groups. No differences were found in graft survival rates at 1 y. CONCLUSIONS: The use of abdominal NRP improves early function recovery of KT from cDCD, making their outcomes comparable with those of DBD.
Authors: R Valero; C Cabrer; F Oppenheimer; E Trias; J Sánchez-Ibáñez; F M De Cabo; A Navarro; D Paredes; A Alcaraz; R Gutiérrez; M Manyalich Journal: Transpl Int Date: 2000 Impact factor: 3.782
Authors: C Fondevila; A J Hessheimer; A Ruiz; D Calatayud; J Ferrer; R Charco; J Fuster; M Navasa; A Rimola; P Taurá; P Ginés; M Manyalich; J C García-Valdecasas Journal: Am J Transplant Date: 2007-07 Impact factor: 8.086
Authors: J C García-Valdecasas; J Tabet; R Valero; P Taurá; R Rull; F García; E Montserrat; F X González; J Ordi; J Beltran; M A López-Boado; R Deulofeu; J Angás; A Cifuentes; J Visa Journal: Transpl Int Date: 1998 Impact factor: 3.782
Authors: R A Wolfe; V B Ashby; E L Milford; A O Ojo; R E Ettenger; L Y Agodoa; P J Held; F K Port Journal: N Engl J Med Date: 1999-12-02 Impact factor: 91.245
Authors: J J Rubio-Muñoz; M Pérez-Redondo; S Alcántara-Carmona; I Lipperheide-Vallhonrat; I Fernández-Simón; M Valdivia-de la Fuente; H Villanueva-Fernández; B Balandín-Moreno; A Ortega-López; M A Romera-Ortega; P Galdos-Anuncibay Journal: Med Intensiva Date: 2013-03-05 Impact factor: 2.491