Microscopic Intrarenal Particles After Pulsatile Machine Preservation Do Not Adversely Affect Outcomes After Renal Transplantation
Our center has recently observed foreign carbohydrate-appearing particles (FP) on transplant postreperfusion biopsy specimens: (PRBx). To further characterize FPs, we reviewed all renal transplant RBx (30–45 minutes) performed between September 1, 2004 and December 3, 2005. Donor, preservation, and...
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| Veröffentlicht in: | Transplantation proceedings 2006-12, Vol.38 (10), p.3384-3387 |
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| creator | Guarrera, J.V. Nasr, S.H. Reverte, C.M. Samstein, B. Brown, T. Balachandran, V. Samuels, M.J. Kelly, J. Hardy, M.A. Markowitz, G.S. D’Agati, V.D. Ratner, L.E. |
| description | Our center has recently observed foreign carbohydrate-appearing particles (FP) on transplant postreperfusion biopsy specimens: (PRBx).
To further characterize FPs, we reviewed all renal transplant RBx (30–45 minutes) performed between September 1, 2004 and December 3, 2005. Donor, preservation, and outcome variables were collected among patients with FP.
A total of 135 PRBx were performed (45 deceased donors [DD] and 90 live donors [LD]). Fifteen PRBx demonstrated FP. All 15 cases were DD kidneys that underwent machine perfusion (MP) on the Waters RM3 (Waters Medical Systems, Rochester, Minn, United States) with Belzer MP solution (Trans Med, Elk River, Minn, United States). Donor age was 39.8 ± 15.7 years. Terminal creatinine level was 1.45 ± 0.8 mg/dL. Two of 15 were flushed in situ with HTK solution (no starch). Cold ischemia time was 28.8 ± 9.1 hours with 14.3 ± 5.1 hours of MP. In 13 of 15 patients, perfusion parameters were excellent (flow > 100 mL; resistance < .35).
Particles were 10–30 μ and globular in shape. FP were not visible on hematoxylin and eosin stain, but stained strongly periodic acid-Schiff–(PAS) positive and were refractile under polarized light. FP were seen segmentally within glomerular capillaries in all cases and in peritubular capillaries in 3. In 11 of the 15 cases with FP, focal glomerular fibrin thrombi or intracapillary neutrophil margination was seen. Ten of 15 patients with FP had a biopsy within the first week with no identifiable FP.
Recipient age was 45.3 ± 11.6 years. Eight patients (53.3%) had delayed graft function. Biopsy-proven rejection occurred in 3 patients (20%). Three-month creatinine level was 1.59 ± 0.35 mg/dL. One graft was lost to early thrombosis in a patient with a hypercoagulable state and 1 patient died of sepsis at 2 months. All remaining 13 patients are alive with excellent graft function at a median follow-up of 6.7 months (range, 3–17 months).
Microscopic intrarenal particles may be seen on DD kidney PRBx after MP. These FPs likely originate from surgical gloves. FPs are too small to be captured by standard filters but clear spontaneously and do not have deleterious effects on renal function or outcomes. |
| doi_str_mv | 10.1016/j.transproceed.2006.10.168 |
| format | Article |
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To further characterize FPs, we reviewed all renal transplant RBx (30–45 minutes) performed between September 1, 2004 and December 3, 2005. Donor, preservation, and outcome variables were collected among patients with FP.
A total of 135 PRBx were performed (45 deceased donors [DD] and 90 live donors [LD]). Fifteen PRBx demonstrated FP. All 15 cases were DD kidneys that underwent machine perfusion (MP) on the Waters RM3 (Waters Medical Systems, Rochester, Minn, United States) with Belzer MP solution (Trans Med, Elk River, Minn, United States). Donor age was 39.8 ± 15.7 years. Terminal creatinine level was 1.45 ± 0.8 mg/dL. Two of 15 were flushed in situ with HTK solution (no starch). Cold ischemia time was 28.8 ± 9.1 hours with 14.3 ± 5.1 hours of MP. In 13 of 15 patients, perfusion parameters were excellent (flow > 100 mL; resistance < .35).
Particles were 10–30 μ and globular in shape. FP were not visible on hematoxylin and eosin stain, but stained strongly periodic acid-Schiff–(PAS) positive and were refractile under polarized light. FP were seen segmentally within glomerular capillaries in all cases and in peritubular capillaries in 3. In 11 of the 15 cases with FP, focal glomerular fibrin thrombi or intracapillary neutrophil margination was seen. Ten of 15 patients with FP had a biopsy within the first week with no identifiable FP.
Recipient age was 45.3 ± 11.6 years. Eight patients (53.3%) had delayed graft function. Biopsy-proven rejection occurred in 3 patients (20%). Three-month creatinine level was 1.59 ± 0.35 mg/dL. One graft was lost to early thrombosis in a patient with a hypercoagulable state and 1 patient died of sepsis at 2 months. All remaining 13 patients are alive with excellent graft function at a median follow-up of 6.7 months (range, 3–17 months).
Microscopic intrarenal particles may be seen on DD kidney PRBx after MP. These FPs likely originate from surgical gloves. FPs are too small to be captured by standard filters but clear spontaneously and do not have deleterious effects on renal function or outcomes.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2006.10.168</identifier><identifier>PMID: 17175278</identifier><identifier>CODEN: TRPPA8</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; Biopsy ; Cadaver ; Carbohydrates - analysis ; Creatinine - blood ; Follow-Up Studies ; Foreign Bodies - pathology ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Humans ; Kidney Glomerulus - cytology ; Kidney Glomerulus - ultrastructure ; Kidney Transplantation - pathology ; Kidney Transplantation - physiology ; Living Donors ; Medical sciences ; Middle Aged ; Organ Preservation - methods ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Time Factors ; Tissue Donors ; Tissue, organ and graft immunology ; Treatment Outcome</subject><ispartof>Transplantation proceedings, 2006-12, Vol.38 (10), p.3384-3387</ispartof><rights>2006 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-378c1d350d52524a37e6c8a1346c354f1976a62763d31f91bd89614d856b48a13</citedby><cites>FETCH-LOGICAL-c408t-378c1d350d52524a37e6c8a1346c354f1976a62763d31f91bd89614d856b48a13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0041134506014163$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18456600$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17175278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guarrera, J.V.</creatorcontrib><creatorcontrib>Nasr, S.H.</creatorcontrib><creatorcontrib>Reverte, C.M.</creatorcontrib><creatorcontrib>Samstein, B.</creatorcontrib><creatorcontrib>Brown, T.</creatorcontrib><creatorcontrib>Balachandran, V.</creatorcontrib><creatorcontrib>Samuels, M.J.</creatorcontrib><creatorcontrib>Kelly, J.</creatorcontrib><creatorcontrib>Hardy, M.A.</creatorcontrib><creatorcontrib>Markowitz, G.S.</creatorcontrib><creatorcontrib>D’Agati, V.D.</creatorcontrib><creatorcontrib>Ratner, L.E.</creatorcontrib><title>Microscopic Intrarenal Particles After Pulsatile Machine Preservation Do Not Adversely Affect Outcomes After Renal Transplantation</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>Our center has recently observed foreign carbohydrate-appearing particles (FP) on transplant postreperfusion biopsy specimens: (PRBx).
To further characterize FPs, we reviewed all renal transplant RBx (30–45 minutes) performed between September 1, 2004 and December 3, 2005. Donor, preservation, and outcome variables were collected among patients with FP.
A total of 135 PRBx were performed (45 deceased donors [DD] and 90 live donors [LD]). Fifteen PRBx demonstrated FP. All 15 cases were DD kidneys that underwent machine perfusion (MP) on the Waters RM3 (Waters Medical Systems, Rochester, Minn, United States) with Belzer MP solution (Trans Med, Elk River, Minn, United States). Donor age was 39.8 ± 15.7 years. Terminal creatinine level was 1.45 ± 0.8 mg/dL. Two of 15 were flushed in situ with HTK solution (no starch). Cold ischemia time was 28.8 ± 9.1 hours with 14.3 ± 5.1 hours of MP. In 13 of 15 patients, perfusion parameters were excellent (flow > 100 mL; resistance < .35).
Particles were 10–30 μ and globular in shape. FP were not visible on hematoxylin and eosin stain, but stained strongly periodic acid-Schiff–(PAS) positive and were refractile under polarized light. FP were seen segmentally within glomerular capillaries in all cases and in peritubular capillaries in 3. In 11 of the 15 cases with FP, focal glomerular fibrin thrombi or intracapillary neutrophil margination was seen. Ten of 15 patients with FP had a biopsy within the first week with no identifiable FP.
Recipient age was 45.3 ± 11.6 years. Eight patients (53.3%) had delayed graft function. Biopsy-proven rejection occurred in 3 patients (20%). Three-month creatinine level was 1.59 ± 0.35 mg/dL. One graft was lost to early thrombosis in a patient with a hypercoagulable state and 1 patient died of sepsis at 2 months. All remaining 13 patients are alive with excellent graft function at a median follow-up of 6.7 months (range, 3–17 months).
Microscopic intrarenal particles may be seen on DD kidney PRBx after MP. These FPs likely originate from surgical gloves. FPs are too small to be captured by standard filters but clear spontaneously and do not have deleterious effects on renal function or outcomes.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Cadaver</subject><subject>Carbohydrates - analysis</subject><subject>Creatinine - blood</subject><subject>Follow-Up Studies</subject><subject>Foreign Bodies - pathology</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Humans</subject><subject>Kidney Glomerulus - cytology</subject><subject>Kidney Glomerulus - ultrastructure</subject><subject>Kidney Transplantation - pathology</subject><subject>Kidney Transplantation - physiology</subject><subject>Living Donors</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Organ Preservation - methods</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Time Factors</subject><subject>Tissue Donors</subject><subject>Tissue, organ and graft immunology</subject><subject>Treatment Outcome</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1uEzEUhS0EoqHwCshCorsJ_h-HXdQCrdTSCJW15dh3hCNnJtieSN3y5HiSqGXJyhrf7xyfORehD5TMKaHq02Zeku3zLg0OwM8ZIWo-zZR-gWZUt7xhivGXaEaIoA3lQp6hNzlvSP1mgr9GZ7SlrWStnqE_d8GlIbthFxy-6atxgt5GvLKpBBch42VXIOHVGLMtIQK-s-5X6AGvEmRI-3o59PhqwN-Hgpd-DylDfKyqDlzB92Nxw_bJ5cfB--GQPtq-HMRv0avOxgzvTuc5-vn1y8PldXN7_-3mcnnbOEF0aXirHfVcEi-ZZMLyFpTTtv6eclyKji5aZRVrFfecdgu69nqhqPBaqrWYuHN0cfStxf0eIRezDdlBrEFgGLNRmkklFqSCn4_g1ExO0JldClubHg0lZtqA2Zh_N2CmDRxmSlfx-9Mr43pbZ0_SU-UV-HgCbHY2dtXIhfzMaSGVIlOKqyMHtZN9gGSyC9A78CHVao0fwv_k-QuPkazI</recordid><startdate>20061201</startdate><enddate>20061201</enddate><creator>Guarrera, J.V.</creator><creator>Nasr, S.H.</creator><creator>Reverte, C.M.</creator><creator>Samstein, B.</creator><creator>Brown, T.</creator><creator>Balachandran, V.</creator><creator>Samuels, M.J.</creator><creator>Kelly, J.</creator><creator>Hardy, M.A.</creator><creator>Markowitz, G.S.</creator><creator>D’Agati, V.D.</creator><creator>Ratner, L.E.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><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></search><sort><creationdate>20061201</creationdate><title>Microscopic Intrarenal Particles After Pulsatile Machine Preservation Do Not Adversely Affect Outcomes After Renal Transplantation</title><author>Guarrera, J.V. ; Nasr, S.H. ; Reverte, C.M. ; Samstein, B. ; Brown, T. ; Balachandran, V. ; Samuels, M.J. ; Kelly, J. ; Hardy, M.A. ; Markowitz, G.S. ; D’Agati, V.D. ; Ratner, L.E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-378c1d350d52524a37e6c8a1346c354f1976a62763d31f91bd89614d856b48a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Cadaver</topic><topic>Carbohydrates - analysis</topic><topic>Creatinine - blood</topic><topic>Follow-Up Studies</topic><topic>Foreign Bodies - pathology</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Humans</topic><topic>Kidney Glomerulus - cytology</topic><topic>Kidney Glomerulus - ultrastructure</topic><topic>Kidney Transplantation - pathology</topic><topic>Kidney Transplantation - physiology</topic><topic>Living Donors</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Organ Preservation - methods</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Time Factors</topic><topic>Tissue Donors</topic><topic>Tissue, organ and graft immunology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guarrera, J.V.</creatorcontrib><creatorcontrib>Nasr, S.H.</creatorcontrib><creatorcontrib>Reverte, C.M.</creatorcontrib><creatorcontrib>Samstein, B.</creatorcontrib><creatorcontrib>Brown, T.</creatorcontrib><creatorcontrib>Balachandran, V.</creatorcontrib><creatorcontrib>Samuels, M.J.</creatorcontrib><creatorcontrib>Kelly, J.</creatorcontrib><creatorcontrib>Hardy, M.A.</creatorcontrib><creatorcontrib>Markowitz, G.S.</creatorcontrib><creatorcontrib>D’Agati, V.D.</creatorcontrib><creatorcontrib>Ratner, L.E.</creatorcontrib><collection>Pascal-Francis</collection><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>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guarrera, J.V.</au><au>Nasr, S.H.</au><au>Reverte, C.M.</au><au>Samstein, B.</au><au>Brown, T.</au><au>Balachandran, V.</au><au>Samuels, M.J.</au><au>Kelly, J.</au><au>Hardy, M.A.</au><au>Markowitz, G.S.</au><au>D’Agati, V.D.</au><au>Ratner, L.E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Microscopic Intrarenal Particles After Pulsatile Machine Preservation Do Not Adversely Affect Outcomes After Renal Transplantation</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2006-12-01</date><risdate>2006</risdate><volume>38</volume><issue>10</issue><spage>3384</spage><epage>3387</epage><pages>3384-3387</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><coden>TRPPA8</coden><abstract>Our center has recently observed foreign carbohydrate-appearing particles (FP) on transplant postreperfusion biopsy specimens: (PRBx).
To further characterize FPs, we reviewed all renal transplant RBx (30–45 minutes) performed between September 1, 2004 and December 3, 2005. Donor, preservation, and outcome variables were collected among patients with FP.
A total of 135 PRBx were performed (45 deceased donors [DD] and 90 live donors [LD]). Fifteen PRBx demonstrated FP. All 15 cases were DD kidneys that underwent machine perfusion (MP) on the Waters RM3 (Waters Medical Systems, Rochester, Minn, United States) with Belzer MP solution (Trans Med, Elk River, Minn, United States). Donor age was 39.8 ± 15.7 years. Terminal creatinine level was 1.45 ± 0.8 mg/dL. Two of 15 were flushed in situ with HTK solution (no starch). Cold ischemia time was 28.8 ± 9.1 hours with 14.3 ± 5.1 hours of MP. In 13 of 15 patients, perfusion parameters were excellent (flow > 100 mL; resistance < .35).
Particles were 10–30 μ and globular in shape. FP were not visible on hematoxylin and eosin stain, but stained strongly periodic acid-Schiff–(PAS) positive and were refractile under polarized light. FP were seen segmentally within glomerular capillaries in all cases and in peritubular capillaries in 3. In 11 of the 15 cases with FP, focal glomerular fibrin thrombi or intracapillary neutrophil margination was seen. Ten of 15 patients with FP had a biopsy within the first week with no identifiable FP.
Recipient age was 45.3 ± 11.6 years. Eight patients (53.3%) had delayed graft function. Biopsy-proven rejection occurred in 3 patients (20%). Three-month creatinine level was 1.59 ± 0.35 mg/dL. One graft was lost to early thrombosis in a patient with a hypercoagulable state and 1 patient died of sepsis at 2 months. All remaining 13 patients are alive with excellent graft function at a median follow-up of 6.7 months (range, 3–17 months).
Microscopic intrarenal particles may be seen on DD kidney PRBx after MP. These FPs likely originate from surgical gloves. FPs are too small to be captured by standard filters but clear spontaneously and do not have deleterious effects on renal function or outcomes.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17175278</pmid><doi>10.1016/j.transproceed.2006.10.168</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Biopsy Cadaver Carbohydrates - analysis Creatinine - blood Follow-Up Studies Foreign Bodies - pathology Fundamental and applied biological sciences. Psychology Fundamental immunology Humans Kidney Glomerulus - cytology Kidney Glomerulus - ultrastructure Kidney Transplantation - pathology Kidney Transplantation - physiology Living Donors Medical sciences Middle Aged Organ Preservation - methods Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Time Factors Tissue Donors Tissue, organ and graft immunology Treatment Outcome |
| title | Microscopic Intrarenal Particles After Pulsatile Machine Preservation Do Not Adversely Affect Outcomes After Renal Transplantation |
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