Graft Function After Kidney Transplantation From Non-Heartbeating Donors According to Maastricht Category

Gok, MA; Asher, John; Shenton, B. K.; Rix, D.; Soomro, Naeem; Jaques, Bryon; Manas, Derek; Talbot, David

doi:10.1097/01.ju.0000145128.00771.14

Cited by 33 publications

(26 citation statements)

References 9 publications

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“…Delayed graft function was seen for 83.8 % of Maastricht Category II, 67.4 % of Maastricht Category III and 0% of Maastricht Category IV. However, one year graft survival was similar among these groups [10].…”

Section: Introductionmentioning

confidence: 77%

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Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Sevinc¹,

Stamp

Carter

et al. 2016

Transplantation Proceedings

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Section: Introductionmentioning

confidence: 77%

“…This was found to be more important for Maastricht Category II kidneys as for controlled donors very few are considered too poor to transplant [10]. The aim of this study is to determine whether machine perfusion characteristics measured prior to transplant are predictive of long-term outcome.…”

Section: Introductionmentioning

confidence: 99%

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Sevinc¹,

Stamp

Carter

et al. 2016

Transplantation Proceedings

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“…However, compared to kidneys retrieved from standard donors, ECD and DCD organs show higher rates of primary failure (PNF) and delayed graft function (DGF) [3][4][5][6]. Inferior renal function and higher discard rates have been also highlighted by several reports.…”

Section: Introductionmentioning

confidence: 93%

Hypothermic Machine Perfusion in Kidney Transplantation: Back to the Future?

Ferraresso¹,

Favi²

2015

J Transplant Technol Res

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Static cold storage is currently the most used method of organ preservation worldwide. However, cutting edge technology and dramatic changes in the donor pattern have lately renewed the interest toward hypothermic machine perfusion. Marginal and cardiac death donors show higher rates of primary non function and delayed graft function compared to standard criteria donors. In this setting, machine perfusion may offer several theoretical advantages such as improved organ preservation, continuous graft evaluation, and ex-vivo conditioning of the graft before implantation. These topics have been recently reassessed by several studies. In particular, perfusion characteristics (renal resistance) and perfusate biomarker concentrations (lactate dehydrogenase, aspartate aminotransferase, heart-type fatty acid binding protein, and IL-18) during machine preservation, proved to be reliable tools to rule out graft viability and predict outcomes after transplantation. Treatment strategies acting on tissue repair, cell metabolism, and allorecognition pathway are also under investigation with promising results. Machine perfusion has finally shown its real potential however, stronger evidences and updated cost-effectiveness analysis are needed to fully support its role for the next future.

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“…The outcomes of livers from uncontrolled DCD donors were poor; only a few reports have been published on liver transplantation using these donors and some form of cardio-pulmonary support was employed in these donors to maintain recirculation [8,21] . Substantial data on renal transplantation from uncontrolled DCD donors exists; however, most liver transplant programs only use controlled DCD donors at present [22] . Initial results following controlled DCD transplantation were acceptable and similar to that of livers from DBD donors; initially this donor organ source was thought to be a supplement to reducing numbers of organs from DBD donor sources.…”

Section: Historical Perspectivesmentioning

confidence: 99%

Current status and recent advances of liver transplantation from donation after cardiac death

Perera

Bramhall

2011

WJGS

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The last decade saw increased organ donation activity from donors after cardiac death (DCD). This contributed to a significant proportion of transplant activity. Despite certain drawbacks, liver transplantation from DCD donors continues to supplement the donor pool on the backdrop of a severe organ shortage. Understanding the pathophysiology has provided the basis for modulation of DCD organs that has been proven to be effective outside liver transplantation but remains experimental in liver transplantation models. Research continues on how best to further increase the utility of DCD grafts. Most of the work has been carried out exploring the use of organ preservation using machine assisted perfusion. Both ex-situ and in-situ organ perfusion systems are tested in the liver transplantation setting with promising results. Additional techniques involved pharmacological manipulation of the donor, graft and the recipient. Ethical barriers and end-of-life care pathways are obstacles to widespread clinical application of some of the recent advances to practice. It is likely that some of the DCD offers are in fact probably "prematurely" offered without ideal donor management or even prior to brain death being established. The absolute benefits of DCD exist only if this form of donation supplements the existing deceased donor pool; hence, it is worthwhile revisiting organ donation process enabling us to identify counter remedial measures.

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Graft Function After Kidney Transplantation From Non-Heartbeating Donors According to Maastricht Category

Abstract: Early graft function is poorest in kidneys derived from Maastricht category II donors and best in category IV with III in-between. However, after 3 months the function of kidneys from all donors is the same.

Cited by 33 publications

References 9 publications

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Hypothermic Machine Perfusion in Kidney Transplantation: Back to the Future?

Current status and recent advances of liver transplantation from donation after cardiac death

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