Outcome of renal allografts from non-heart-beating donors with delayed graft function

Gerstenkorn, C.; Deardon, David; Koffman, C.G.; Papalois, Vassilios; Andrews, Peter

doi:10.1007/s00147-002-0471-4

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…48 Gerstenkorn et al determined DGF to be associated with excellent long-term survival. 49 According to Sanchez-Fructuoso et al, DGF is a risk factor for poor survival of kidneys from heartbeating donors, but not for grafts from NHB donors. 17 We have shown that prolonged DGF of kidneys from NHB donors has a negative effect on creatinine clearance but not on graft survival.…”

Section: Discussionmentioning

confidence: 98%

Non-heartbeating donation of kidneys for transplantation

Kootstra¹,

Heurn²

2007

Nat Rev Nephrol

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There is a persistent shortage of kidneys available for transplantation. In the early 1980s, therefore, we published the concept of non-heartbeating (NHB) donation; that is, procurement of kidneys from donors whose death has been accompanied by irreversible circulatory arrest. NHB donors are generally categorized using four definitions; category III (awaiting cardiac arrest) and category IV (cardiac arrest while braindead)--or 'controlled'--donors are the most suitable for initiating NHB donation programs. Delayed graft function is associated with use of kidneys from such donors, but has no effect on graft survival in the short or long term. Use of kidneys from category I (dead upon arrival at hospital) and category II (unsuccessfully resuscitated), or 'uncontrolled', donors is likewise associated with delayed graft function, but also with an increased risk of primary nonfunction. Viability testing of donated organs from these sources is a prerequisite for transplantation. Machine preservation parameters and enzyme release measurements help to distinguish viable from nonviable kidneys. The proportion of NHB donor kidneys in the total pool of postmortem kidneys differs considerably between countries. In The Netherlands, the proportion is nearly 50%. This figure is markedly higher than that in the US and Canada, where national programs have now been initiated to increase rates of NHB donation. In the future, warm preservation techniques might facilitate better viability testing, thereby increasing NHB donation from category I and II donors and further reducing the shortage of kidneys available for transplantation.

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Section: Discussionmentioning

confidence: 98%

Non-heartbeating donation of kidneys for transplantation

Kootstra¹,

Heurn²

2007

Nat Rev Nephrol

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“…The use of machine perfusion appeared to reduce the PNF rate but without amelioration of the DGF rate (7,8). Graft survival, early and long‐term kidney outcome from cDDCA seemed to be similar to those with matched heart beating donors, except for a higher rate of DGF that did not influence the long‐term kidney graft function (4,6,9–14).…”

Section: Introductionmentioning

confidence: 83%

Kidney Graft Outcome and Quality (After Transplantation) From Uncontrolled Deceased Donors After Cardiac Arrest

Hanf

Codas

Meas-Yedid

et al. 2012

American Journal of Transplantation

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The use of uncontrolled deceased donors after cardiac arrest (uDDCA) has been developed in France to compensate for organ shortage. The quality of these kidneys remains unclear. We analyzed kidney graft function and histology from 27 uDDCA and compared them with kidneys from 30 extended criteria donors (ECD) and from 24 simultaneous pancreas kidney (SPK) donors as a control group of optimal deceased donors. Kidneys from ECD and SPK donors were preserved by static cold storage while kidneys from uDDCA were preserved by pulsatile perfusion.

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“…RENAL TRANSPLANTATION is effective for the management of human and feline patients with end‐stage renal failure. In human renal transplantation, renal allografts with immediate, excellent function have good long‐term outcomes, whereas allografts with delayed allograft function have an increased incidence of acute rejection, poor long‐term graft function, and reduced patient survival 2,3 …”

Section: Introductionmentioning

confidence: 99%