Analysis of factors that affect outcome after transplantation of kidneys donated after cardiac death in the UK: a cohort study

Summers, Dominic M.; Rj, Johnson; Allen, Joanne; Fuggle, Susan V.; Collett, David; Watson, Christopher J.; Bradley, J. Andrew

doi:10.1016/s0140-6736(10)60827-6

Cited by 319 publications

(282 citation statements)

References 27 publications

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“…Organs can be also harvested from non-heart beating donors (NHBD). According to Summers et al the results of kidney transplantation of that kind of organs can be compared to the results of brain death donors' organ transplantation results [3][4][5][6]. In our study we proved that patients, who received a kidney from a donor with intracranial bleeding, had had worse kidney graft function in comparison with recipients who received a kidney from a donor with cranial injury.…”

Section: Discussionsupporting

confidence: 55%

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Kieszek¹,

Jędrzejko²

2015

J Transplant Technol Res

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Section: Discussionsupporting

confidence: 55%

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Kieszek¹,

Jędrzejko²

2015

J Transplant Technol Res

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“…Univariable Cox regression analysis showed that established chronic kidney injury and ECD status were associated with higher risk of graft failure (Table 3). However, on multivariable analysis (Table 4) (3,4,18), donor age was also not associated with transplant survival (Table 4), perhaps reflecting the smaller transplant numbers and relatively shorter follow-up of patients in our single-center study. However, on multiple linear regression modelling, donor age was the strongest predictor of graft function (eGFR) at 1 year, with every additional year in donor age associated with 0.25 mL/min/m 2 decrease in 1 year eGFR (Table 5A).…”

Section: Resultsmentioning

confidence: 80%

“…This has been achieved despite marked variation between transplant centers in their use of DCD kidneys, particularly those from extended criteria donors (1,2). Such center variation persists (2), despite increasing evidence that outcomes for DCD and conventional donation after brain death (DBD) kidney transplants are similar (3,4). The ongoing concern regarding selection of DCD kidneys for transplantation is apparent in analysis of discard rates of deceased donor kidneys in the United Kingdom; for donors over 60 years, approximately three quarters of offered DBD kidneys are implanted, whereas less than a third of offered DCD kidneys are implanted (5).…”

Section: Introductionmentioning

confidence: 99%

Baseline Donor Chronic Renal Injury Confers the Same Transplant Survival Disadvantage for DCD and DBD Kidneys

Kosmoliaptsis

Salji

Bardsley

et al. 2015

American Journal of Transplantation

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Histological assessment of baseline chronic kidney injury may discriminate kidneys that are suitable for transplantation, but has not been validated for appraisal of donation after circulatory death (DCD) kidneys. 'Time-zero' biopsies for 371 consecutive, solitary, deceased-donor kidneys transplanted at our center between 2006 and 2010 (65.5% DCD, 34.5% donation after brain death [DBD]) were reviewed and baseline chronic degenerative injury scored using Remuzzi's classification. High scores correlated with donor age and extended criteria donors (42% of donors), but the spectrum of scores was similar for DCD and DBD kidneys. Transplant outcomes for kidneys scoring from 0 to 4 were comparable (1 and 3 year graft survival 95% and 92%), but were much poorer for kidneys scoring !5, with 1 year graft survival only 73%, and 12.5% suffering primary nonfunction. Critically, high Remuzzi scores conferred the same survival disadvantage for DCD and DBD kidneys. On multi-variable regression analysis, time-zero biopsy score was the only independent predictor for graft survival, whereas one-year graft estimated glomerular filtration rate (eGFR) correlated with donor age and biopsy score. In conclusion, the relationship between severity of chronic kidney injury and transplant outcome is similar for DCD and DBD kidneys. Kidneys with Remuzzi scores of 4 can be implanted singly with acceptable results.

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“…2 A cold ischemia time of less than 12 h is strongly associated with superior graft survival, but few kidneys from cardiac-death donors have such a short cold ischemic time. 3 Demand for kidney transplantation (KTx) far exceeds the supply of donor organs, and the shortfall is becoming more severe as donor numbers fail to keep pace with the increasing numbers of patients listed for transplantation. 4 The current shortage of deceased-donor kidney grafts means that surgeons are now transplanting organs that would previously have been considered unacceptable, such as those from non-heart-beating donors.…”

mentioning

confidence: 99%

High-pressure carbon monoxide preserves rat kidney grafts from apoptosis and inflammation

Abe

Yazawa

Fujino

et al. 2017

Laboratory Investigation

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Renal ischemia-reperfusion (I/R) injury is unavoidable in kidney transplantation (KTx) and frequently influences both short-and long-term allograft survival. Carbon monoxide (CO) has attracted attention as a medical gas with anti-inflammatory and anti-apoptotic effects. We investigated a new strategy for organ preservation using ex vivo application of high-pressure CO in an experimental rat KTx model. We preserved kidney grafts using a high-pressure chamber filled with mixed gases composed of CO and O 2 . We found that cold I/R injury resulted in progressive deterioration of renal graft function in University of Wisconsin solution, whereas CO significantly improved renal function. We confirmed that CO decreased oxidative stress and mRNA expression of proinflammatory cytokines and inhibited tubular apoptosis in the early phases. Western blot analysis demonstrated that CO increased phosphatidylinositol-3 kinase and phosphorylation of Akt and p38 mitogen-activated protein kinase. Furthermore, CO significantly alleviated tubular injury scores and suppressed the development of interstitial fibrosis at 100 days after KTx. Thus, high-pressure mixed CO and O 2 gases successfully preserved rat kidney grafts for 24 h by protecting tubular epithelial cells from apoptosis and inhibiting inflammation.

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Analysis of factors that affect outcome after transplantation of kidneys donated after cardiac death in the UK: a cohort study

Cited by 319 publications

References 27 publications

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Baseline Donor Chronic Renal Injury Confers the Same Transplant Survival Disadvantage for DCD and DBD Kidneys

High-pressure carbon monoxide preserves rat kidney grafts from apoptosis and inflammation

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