Hypothermic Machine Perfusion Results in a Marginal Kidney Transplant Programme
Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results. To identify factors im...
Gespeichert in:
| Veröffentlicht in: | European urology focus 2018-03, Vol.4 (2), p.163-168 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 168 |
|---|---|
| container_issue | 2 |
| container_start_page | 163 |
| container_title | European urology focus |
| container_volume | 4 |
| creator | Gómez-Dos Santos, Victoria Ruiz Hernández, Mercedes Burgos-Revilla, Francisco Javier |
| description | Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results.
To identify factors impacting HMP in transplantation from marginal donors.
Analysis of prospectively collected cohort data of expanded criteria donor (ECD) and donor after circulatory death (DCD) categories II and III was performed. A total of 214 adult recipients of first kidney transplantation with complete data and a minimum of 6-mo follow-up were included.
Delayed graft function (DGF) was defined as the lack of decrease in creatinine level in the first 48h. Graft loss was defined as return to dialysis or creatinine clearance |
| doi_str_mv | 10.1016/j.euf.2018.05.011 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2058504691</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2405456918301457</els_id><sourcerecordid>2058504691</sourcerecordid><originalsourceid>FETCH-LOGICAL-c353t-e9471b115f8d900935f6a164ce5f0ed520e93d78463847f5b08ac0fef45e79de3</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMottT-AC-yRy9dJ7vJ7gZPUtSKlRap55BmJ23KfpnsCv33bmkVT55mYJ55mXkIuaYQUqDJ3S7EzoQR0CwEHgKlZ2QYMeATxhNx_qcfkLH3OwCgnKVxFl-SQSREJLI0GpLFbN_U7RZdaXXwpvTWVhgs0ZnO27oK3tF3ResDWwWqH7uNrVQRvNq8wn2wcqryTaGqNli6euNUWeIVuTCq8Dg-1RH5eHpcTWeT-eL5Zfown-iYx-0EBUvpmlJuslwAiJibRNGEaeQGMOcRoIjzNGNJnLHU8DVkSoNBwzimIsd4RG6PuY2rPzv0rSyt11j012DdeRkBzziwRNAepUdUu9p7h0Y2zpbK7SUFeVApd7JXKQ8qJXDZq-x3bk7x3brE_HfjR1wP3B8B7J_8suik1xYrjbl1qFuZ1_af-G83VYO8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2058504691</pqid></control><display><type>article</type><title>Hypothermic Machine Perfusion Results in a Marginal Kidney Transplant Programme</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Gómez-Dos Santos, Victoria ; Ruiz Hernández, Mercedes ; Burgos-Revilla, Francisco Javier</creator><creatorcontrib>Gómez-Dos Santos, Victoria ; Ruiz Hernández, Mercedes ; Burgos-Revilla, Francisco Javier</creatorcontrib><description>Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results.
To identify factors impacting HMP in transplantation from marginal donors.
Analysis of prospectively collected cohort data of expanded criteria donor (ECD) and donor after circulatory death (DCD) categories II and III was performed. A total of 214 adult recipients of first kidney transplantation with complete data and a minimum of 6-mo follow-up were included.
Delayed graft function (DGF) was defined as the lack of decrease in creatinine level in the first 48h. Graft loss was defined as return to dialysis or creatinine clearance <15ml/min/1.73m2. Univariate and multivariate logistic regression analyses for DGF were constructed to identify independent risk factors. Recipient and graft survival (GS) analyses were conducted by Kaplan-Meier, and univariate and multivariate Cox regression analyses.
DGF occurred in 32.8% of imported and 20.5% of local grafts (p=0.059). Only donor category (DCD; odds ratio [OR]: 6.6, p=0.008) and haemodialysis (OR: 3.5, p=0.002) were significantly associated with DGF development. The 1-yr GS rate was 92.5% in the local donor group and 84.3% in the imported donor group (p=0.050). Multivariate analysis by Cox proportional hazards model identified only donor category (hazard ratio [HR] 10.99, p=0.001) and donor age (HR 1.07, p=0.005) as predictive variables for GS. The small sample size of the DCD group diminished the statistical power and did not permit a subgroup analysis to determine the impact of specific DCD category on HMP results.
DCD donor category, but not donor centre of origin, impacted DGF development and GS in the HMP of deceased donor kidneys.
Currently, the number of donors is insufficient to meet the demand for renal grafts. Expanded criteria for donation after brain death and donation after circulatory death (DCD) programmes have been developed as strategies to minimise this problem. Hypothermic machine perfusion has previously demonstrated its usefulness in expanded criteria donation and DCD preservation. DCD type and donor age increase the risk of graft loss.
Donor origin was not related to delayed graft function development or graft survival. The study suggested that static cold storage prior to hypothermic machine perfusion has no significant effect in marginal donor transplants under machine preservation. However, donor category, specifically donor after circulatory death, increased graft loss risk.</description><identifier>ISSN: 2405-4569</identifier><identifier>EISSN: 2405-4569</identifier><identifier>DOI: 10.1016/j.euf.2018.05.011</identifier><identifier>PMID: 29929872</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aged ; Aged, 80 and over ; Brain Death - physiopathology ; Brain death donor ; Cryopreservation - methods ; Delayed graft function ; Delayed Graft Function - physiopathology ; Donor after circulatory death ; Expanded criteria donor ; Female ; Graft Survival - physiology ; Humans ; Hypothermic machine perfusion ; Kidney transplantation ; Kidney Transplantation - adverse effects ; Male ; Middle Aged ; Organ preservation ; Organ Preservation - adverse effects ; Organ Preservation - methods ; Prospective Studies ; Risk Factors ; Tissue and Organ Procurement - methods ; Tissue Donors - statistics & numerical data</subject><ispartof>European urology focus, 2018-03, Vol.4 (2), p.163-168</ispartof><rights>2018 European Association of Urology</rights><rights>Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-e9471b115f8d900935f6a164ce5f0ed520e93d78463847f5b08ac0fef45e79de3</citedby><cites>FETCH-LOGICAL-c353t-e9471b115f8d900935f6a164ce5f0ed520e93d78463847f5b08ac0fef45e79de3</cites><orcidid>0000-0003-2968-148X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29929872$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gómez-Dos Santos, Victoria</creatorcontrib><creatorcontrib>Ruiz Hernández, Mercedes</creatorcontrib><creatorcontrib>Burgos-Revilla, Francisco Javier</creatorcontrib><title>Hypothermic Machine Perfusion Results in a Marginal Kidney Transplant Programme</title><title>European urology focus</title><addtitle>Eur Urol Focus</addtitle><description>Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results.
To identify factors impacting HMP in transplantation from marginal donors.
Analysis of prospectively collected cohort data of expanded criteria donor (ECD) and donor after circulatory death (DCD) categories II and III was performed. A total of 214 adult recipients of first kidney transplantation with complete data and a minimum of 6-mo follow-up were included.
Delayed graft function (DGF) was defined as the lack of decrease in creatinine level in the first 48h. Graft loss was defined as return to dialysis or creatinine clearance <15ml/min/1.73m2. Univariate and multivariate logistic regression analyses for DGF were constructed to identify independent risk factors. Recipient and graft survival (GS) analyses were conducted by Kaplan-Meier, and univariate and multivariate Cox regression analyses.
DGF occurred in 32.8% of imported and 20.5% of local grafts (p=0.059). Only donor category (DCD; odds ratio [OR]: 6.6, p=0.008) and haemodialysis (OR: 3.5, p=0.002) were significantly associated with DGF development. The 1-yr GS rate was 92.5% in the local donor group and 84.3% in the imported donor group (p=0.050). Multivariate analysis by Cox proportional hazards model identified only donor category (hazard ratio [HR] 10.99, p=0.001) and donor age (HR 1.07, p=0.005) as predictive variables for GS. The small sample size of the DCD group diminished the statistical power and did not permit a subgroup analysis to determine the impact of specific DCD category on HMP results.
DCD donor category, but not donor centre of origin, impacted DGF development and GS in the HMP of deceased donor kidneys.
Currently, the number of donors is insufficient to meet the demand for renal grafts. Expanded criteria for donation after brain death and donation after circulatory death (DCD) programmes have been developed as strategies to minimise this problem. Hypothermic machine perfusion has previously demonstrated its usefulness in expanded criteria donation and DCD preservation. DCD type and donor age increase the risk of graft loss.
Donor origin was not related to delayed graft function development or graft survival. The study suggested that static cold storage prior to hypothermic machine perfusion has no significant effect in marginal donor transplants under machine preservation. However, donor category, specifically donor after circulatory death, increased graft loss risk.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brain Death - physiopathology</subject><subject>Brain death donor</subject><subject>Cryopreservation - methods</subject><subject>Delayed graft function</subject><subject>Delayed Graft Function - physiopathology</subject><subject>Donor after circulatory death</subject><subject>Expanded criteria donor</subject><subject>Female</subject><subject>Graft Survival - physiology</subject><subject>Humans</subject><subject>Hypothermic machine perfusion</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ preservation</subject><subject>Organ Preservation - adverse effects</subject><subject>Organ Preservation - methods</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Tissue and Organ Procurement - methods</subject><subject>Tissue Donors - statistics & numerical data</subject><issn>2405-4569</issn><issn>2405-4569</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMottT-AC-yRy9dJ7vJ7gZPUtSKlRap55BmJ23KfpnsCv33bmkVT55mYJ55mXkIuaYQUqDJ3S7EzoQR0CwEHgKlZ2QYMeATxhNx_qcfkLH3OwCgnKVxFl-SQSREJLI0GpLFbN_U7RZdaXXwpvTWVhgs0ZnO27oK3tF3ResDWwWqH7uNrVQRvNq8wn2wcqryTaGqNli6euNUWeIVuTCq8Dg-1RH5eHpcTWeT-eL5Zfown-iYx-0EBUvpmlJuslwAiJibRNGEaeQGMOcRoIjzNGNJnLHU8DVkSoNBwzimIsd4RG6PuY2rPzv0rSyt11j012DdeRkBzziwRNAepUdUu9p7h0Y2zpbK7SUFeVApd7JXKQ8qJXDZq-x3bk7x3brE_HfjR1wP3B8B7J_8suik1xYrjbl1qFuZ1_af-G83VYO8</recordid><startdate>201803</startdate><enddate>201803</enddate><creator>Gómez-Dos Santos, Victoria</creator><creator>Ruiz Hernández, Mercedes</creator><creator>Burgos-Revilla, Francisco Javier</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2968-148X</orcidid></search><sort><creationdate>201803</creationdate><title>Hypothermic Machine Perfusion Results in a Marginal Kidney Transplant Programme</title><author>Gómez-Dos Santos, Victoria ; Ruiz Hernández, Mercedes ; Burgos-Revilla, Francisco Javier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-e9471b115f8d900935f6a164ce5f0ed520e93d78463847f5b08ac0fef45e79de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brain Death - physiopathology</topic><topic>Brain death donor</topic><topic>Cryopreservation - methods</topic><topic>Delayed graft function</topic><topic>Delayed Graft Function - physiopathology</topic><topic>Donor after circulatory death</topic><topic>Expanded criteria donor</topic><topic>Female</topic><topic>Graft Survival - physiology</topic><topic>Humans</topic><topic>Hypothermic machine perfusion</topic><topic>Kidney transplantation</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ preservation</topic><topic>Organ Preservation - adverse effects</topic><topic>Organ Preservation - methods</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Tissue and Organ Procurement - methods</topic><topic>Tissue Donors - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gómez-Dos Santos, Victoria</creatorcontrib><creatorcontrib>Ruiz Hernández, Mercedes</creatorcontrib><creatorcontrib>Burgos-Revilla, Francisco Javier</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European urology focus</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gómez-Dos Santos, Victoria</au><au>Ruiz Hernández, Mercedes</au><au>Burgos-Revilla, Francisco Javier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypothermic Machine Perfusion Results in a Marginal Kidney Transplant Programme</atitle><jtitle>European urology focus</jtitle><addtitle>Eur Urol Focus</addtitle><date>2018-03</date><risdate>2018</risdate><volume>4</volume><issue>2</issue><spage>163</spage><epage>168</epage><pages>163-168</pages><issn>2405-4569</issn><eissn>2405-4569</eissn><abstract>Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage, predominantly in marginal donors. Nevertheless, there is little evidence supporting whether graft centre of origin and donor category impact HMP results.
To identify factors impacting HMP in transplantation from marginal donors.
Analysis of prospectively collected cohort data of expanded criteria donor (ECD) and donor after circulatory death (DCD) categories II and III was performed. A total of 214 adult recipients of first kidney transplantation with complete data and a minimum of 6-mo follow-up were included.
Delayed graft function (DGF) was defined as the lack of decrease in creatinine level in the first 48h. Graft loss was defined as return to dialysis or creatinine clearance <15ml/min/1.73m2. Univariate and multivariate logistic regression analyses for DGF were constructed to identify independent risk factors. Recipient and graft survival (GS) analyses were conducted by Kaplan-Meier, and univariate and multivariate Cox regression analyses.
DGF occurred in 32.8% of imported and 20.5% of local grafts (p=0.059). Only donor category (DCD; odds ratio [OR]: 6.6, p=0.008) and haemodialysis (OR: 3.5, p=0.002) were significantly associated with DGF development. The 1-yr GS rate was 92.5% in the local donor group and 84.3% in the imported donor group (p=0.050). Multivariate analysis by Cox proportional hazards model identified only donor category (hazard ratio [HR] 10.99, p=0.001) and donor age (HR 1.07, p=0.005) as predictive variables for GS. The small sample size of the DCD group diminished the statistical power and did not permit a subgroup analysis to determine the impact of specific DCD category on HMP results.
DCD donor category, but not donor centre of origin, impacted DGF development and GS in the HMP of deceased donor kidneys.
Currently, the number of donors is insufficient to meet the demand for renal grafts. Expanded criteria for donation after brain death and donation after circulatory death (DCD) programmes have been developed as strategies to minimise this problem. Hypothermic machine perfusion has previously demonstrated its usefulness in expanded criteria donation and DCD preservation. DCD type and donor age increase the risk of graft loss.
Donor origin was not related to delayed graft function development or graft survival. The study suggested that static cold storage prior to hypothermic machine perfusion has no significant effect in marginal donor transplants under machine preservation. However, donor category, specifically donor after circulatory death, increased graft loss risk.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>29929872</pmid><doi>10.1016/j.euf.2018.05.011</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2968-148X</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2405-4569 |
| ispartof | European urology focus, 2018-03, Vol.4 (2), p.163-168 |
| issn | 2405-4569 2405-4569 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2058504691 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Brain Death - physiopathology Brain death donor Cryopreservation - methods Delayed graft function Delayed Graft Function - physiopathology Donor after circulatory death Expanded criteria donor Female Graft Survival - physiology Humans Hypothermic machine perfusion Kidney transplantation Kidney Transplantation - adverse effects Male Middle Aged Organ preservation Organ Preservation - adverse effects Organ Preservation - methods Prospective Studies Risk Factors Tissue and Organ Procurement - methods Tissue Donors - statistics & numerical data |
| title | Hypothermic Machine Perfusion Results in a Marginal Kidney Transplant Programme |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T11%3A31%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hypothermic%20Machine%20Perfusion%20Results%20in%20a%20Marginal%20Kidney%20Transplant%20Programme&rft.jtitle=European%20urology%20focus&rft.au=G%C3%B3mez-Dos%20Santos,%20Victoria&rft.date=2018-03&rft.volume=4&rft.issue=2&rft.spage=163&rft.epage=168&rft.pages=163-168&rft.issn=2405-4569&rft.eissn=2405-4569&rft_id=info:doi/10.1016/j.euf.2018.05.011&rft_dat=%3Cproquest_cross%3E2058504691%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2058504691&rft_id=info:pmid/29929872&rft_els_id=S2405456918301457&rfr_iscdi=true |