Agonal phase, ischaemic times, and renal vascular abnormalities and outcome of cadaver kidney transplants.

Hall, Clive L.; Sansom, J R; Obeid, Mahmoud; Dawson-Edwards, P.; Robinson, Brian H.; Barnes, A. D.; Blainey, J. D.

doi:10.1136/bmj.3.5985.667

Cited by 14 publications

(6 citation statements)

References 12 publications

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“…This confirms the results of others (Simmons et al, 1971;Goldman et al, 1975;Hall et al, 1975). However, Bewick et al (1976) have shown that if all arteries are transplanted on a single arterial patch, the use of kidneys with multiple arteries is not associated with an increased incidence of complications.…”

Section: Discussionsupporting

confidence: 88%

Anatomical variations of the renal arteries and renal transplantation

Coen

Raftery

1992

Clinical Anatomy

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This study reports a retrospective analysis of the details of the anatomy of the renal arteries of 403 kidney donors and the arterial complications related to 513 subsequent kidney transplants in our transplant unit. Multiple renal arteries occurred bilaterally in 10.2% of donors and unilaterally in 20.8%, a total incidence of 31%. There was a higher incidence of vascular-related complications following transplantation of kidneys with multiple renal arteries. Attention is drawn to the need for careful technique in identification of multiple renal vessels, especially aberrant vessels, at the time of donor nephrectomy and also to the different techniques available for anastomosis of multiple renal arteries in kidney transplant recipients.

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Section: Discussionsupporting

confidence: 88%

Anatomical variations of the renal arteries and renal transplantation

Coen

Raftery

1992

Clinical Anatomy

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“…The graft survival at 2 years is r\, 100% better in cases with 0 incompatibilities as compared to cases with 2 incompatibilities. When the results obtained in 41 previously transplanted patients were analysed very similar curves were obtained as previously reported (5). It can be added that very similar results were found in the Oslo material [6] and this still holds in a more recent analysis [7] where it was also shown that including matching for the HLA-C series antigens did not influence the results obtained in the '0'mismatch group.…”

Section: The Correlation Between Hla-a and B Matching And Graft Survivalsupporting

confidence: 80%

Fifteen Years of HL‐A: What is the Importance of HL‐A Compatibility for Clinical Outcome of Renal Transplantations?

1978

Vox Sanguinis

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“…Consensus reports on DCD kidney transplantation recommend limiting the time between therapy withdrawal and start of cold in situ perfusion in DCD donors to 1 hour . These recommendations are based on expert opinions and historical analyses, whereas recent studies investigating the effect of donor asystolic warm ischemia time (DWIT), defined as time from circulatory arrest until cold perfusion, failed to demonstrate an effect on graft survival …”

Section: Introductionmentioning

confidence: 99%

The duration of asystolic ischemia determines the risk of graft failure after circulatory-dead donor kidney transplantation: A Eurotransplant cohort study

Heylen

Jochmans

Samuel

et al. 2018

American Journal of Transplantation

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Circulatory death donor (DCD) kidney transplantations are steadily increasing. Consensus reports recommend limiting donor warm ischemia time (DWIT) in DCD donation, although an independent effect on graft outcome has not been demonstrated. We investigated death-censored graft survival in 18 065 recipients of deceased-donor kidney transplants in the Eurotransplant region: 1059 DCD and 17 006 brain-dead donor (DBD) kidney recipients. DWIT was defined as time from circulatory arrest until cold flush. DCD donation was an independent risk factor for graft failure (adjusted hazard ratio [HR] 1.28, 95% CI 1.10-1.46), due to an increased risk of primary nonfunction (62/1059 vs 560/17 006; P < .0001). With DWIT in the model, DCD donation was no longer a risk factor, demonstrating that DWIT explains the inferior graft survival of DCD kidneys. Indeed, DCD transplants with short DWIT have graft survival comparable to that of standard-criteria DBD transplants (P = .59). DWIT also associated with graft failure in DCDs (adjusted HR 1.20 per 10-minute increase, 95% CI 1.03-1.42). At 5 years after transplantation, graft failure occurred in 14 of 133 recipients (10.5%) with DWIT <10 minutes, 139 of 555 recipients (25.0%) with DWIT between 10 and 19 minutes, and 117 of 371 recipients (31.5%) with DWIT ≥20 minutes. These findings support the expert opinion-based guidelines to limit DWIT.

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Agonal phase, ischaemic times, and renal vascular abnormalities and outcome of cadaver kidney transplants.

Cited by 14 publications

References 12 publications

Anatomical variations of the renal arteries and renal transplantation

Anatomical variations of the renal arteries and renal transplantation

Fifteen Years of HL‐A: What is the Importance of HL‐A Compatibility for Clinical Outcome of Renal Transplantations?

The duration of asystolic ischemia determines the risk of graft failure after circulatory-dead donor kidney transplantation: A Eurotransplant cohort study

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