Machine perfusion (MP) has been used as the kidney preservation method in our center for over 10 years. The first, small (n = 74) prospective, single-blinded randomized study comparing MP and Cold Storage (CS) showed that the incidence of delayed graft function was higher after CS. There have been no reports in the literature on the effect of storage modality on longterm function of renal allografts. This paper presents an analysis of long-term results of renal transplantation in 415 patients operated on between 1994 and 1999. Of those, 227 kidneys were MP-stored prior to KTx. The control group consisted of 188 CS kidney transplants. Kidneys were not randomized to MP or to CS. Donor demographics, medical and biochemical data, cold ischemia time, HLA match and recipient data were collected. Standard triple-drug immunosuppression was administered to both groups. Mortality, graft survival and incidence of return to hemodialysis treatment were analyzed. Despite longer cold ischemia time and poorer donor hemodynamics in MP group, 5-year Kaplan-Meier graft survival was better in MP-stored than in CS-stored kidneys (68.2% vs. 54.2%, p = 0.02). Conclusion: In this nonrandomized analysis, kidney storage by MP improved graft survival and reduced the number of patients who returned to dialysis.
The issues related to haemostatic disorders and their treatment are being widely discussed in the literature concerning the diagnosis and management of patients diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) [1][2][3]. The findings of numerous worldwide studies have demonstrated that the haemostatic system is one of the most important systems substantially impaired by the viral infection, which can result in serious life-threatening complications [4][5][6]. It is already known that hypercoagulation [7,8] is the dominant coagulopathy in patients infected with SARS-CoV-2. Its consequences in the form of blood clots and emboli in the blood vessels of various organs in combination with thrombocytopathy lead to severe disorders of haemostasis in some patients and require ICU treatment [9][10][11]. According to the literature data, the incidence of thromboembolic incidents in this group of patients reaches 43% and increases with the length of hospitalization [12,13]. The incidence of pulmonary embolism, which is observed most frequently, is six-fold higher in patients
Background:
There are many doubts with regards to accepting deceased kidneys with acute kidney injury (AKI) for transplantation.
Purpose:
The aim of this study was to present the 5-years outcome of kidney transplantation cases where deceased donors developed AKI before organ procurement.
Methods:
Two hundred twenty-six deceased renal transplants were analyzed. Data regarding donors and recipients were collected. Terminal AKI was defined as terminal serum creatinine concentration higher than 1.99 mg/dL and 66 such cases were diagnosed. All kidney transplant recipients were followed for 60 months.
Results:
AKI group presented more episodes of delayed graft function (DGF) compared to the non-AKI group (56% vs 35%,
p
< .05). No differences were observed between the groups in the rate of acute rejection episodes, kidney function as well as patient and graft survival.
Conclusions:
Transplants with AKI present more often DGF and comparable graft survival to transplants without AKI. Kidneys with AKI can be a valuable source of organs provided attentive selection and appropriate care of deceased donors.
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