Long‐term outcome of kidney transplant using non‐heart‐beating donor: multicenter analysis of factors affecting graft survival

Hattori, Ryohei; Ono, Yoshinari; Yoshimura, Norio; Hoshinaga, Kiyotaka; Nishioka, Tsukasa; Ishibashi, M; Ohshima, Shinichi

doi:10.1046/j.1399-0012.2003.00080.x

Cited by 21 publications

(19 citation statements)

References 11 publications

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“…24 Rates of graft survival at 1, 5 and 10 years were 87%, 69% and 53%, respectively. Poor graft survival was asso ciated with donor age exceeding 55 years.…”

Section: Open Single-center Studiesmentioning

confidence: 94%

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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“…24 Rates of graft survival at 1, 5 and 10 years were 87%, 69% and 53%, respectively. Poor graft survival was asso ciated with donor age exceeding 55 years.…”

Section: Open Single-center Studiesmentioning

confidence: 94%

Non-heartbeating donation of kidneys for transplantation

Kootstra¹,

Heurn²

2007

Nat Rev Nephrol

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“…In a series of 242 kidney transplants, Mizutani et al [10] reported lower graft survival for recipients of kidneys aged >60 years compared with the younger uDCD donor group. These results were confirmed in a retrospective study of 706 kidney transplants from uDCD donors, where donor age >55 years had a negative impact on long-term graft survival [11]. In one of the largest series published, S anchez-Fructuoso et al [13] described that 1and 5-year graft survival for kidneys from uDCD donors with a maximum age of 60 years was similar to that of kidneys from DBD donors <60 and significantly better than that of kidneys from DBD donors ≥60 years.…”

Section: Donor Identification and Referralmentioning

confidence: 57%

“… reported lower graft survival for recipients of kidneys aged >60 years compared with the younger uDCD donor group. These results were confirmed in a retrospective study of 706 kidney transplants from uDCD donors, where donor age >55 years had a negative impact on long‐term graft survival . In one of the largest series published, Sánchez‐Fructuoso et al .…”

Section: Ethical‐regulatory Framework Practices and Evidencementioning

confidence: 69%

“…uDCD relates to excellent long-term kidney graft survival, despite an increased incidence of primary nonfunction (PNF) and delayed graft function (DGF) [9][10][11][12][13][14][15][16][17][18][19][20][21]. The results of liver transplantation from uDCD donors are mixed and do not consistently provide similar outcomes compared with livers from donation after brain death (DBD) donors, mainly because of a higher incidence of primary graft dysfunction, graft nonfunction and biliary complications [22][23][24][25][26][27].…”

Section: Introduction/backgroundmentioning

confidence: 99%

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Uncontrolled donation after circulatory death: European practices and recommendations for the development and optimization of an effective programme

et al. 2016

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SUMMARYThe shortage of organs remains one of the biggest challenges in transplantation. To address this, we are increasingly turning to donation after circulatory death (DCD) donors and now in some countries to uncontrolled DCD donors. We consolidate the knowledge on uncontrolled DCD in Europe and provide recommendations and guidance for the development and optimization of effective uncontrolled DCD programmes.

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“…Until recently, DCD was the only deceased organ donation practice in Japan. 3 European countries have been utilizing DCD organs for donation for more than 20 years, 4 and in the USA, DCD practices have been in place for at least the last decade, and even longer in a few regions. 5 In contrast, Canada abandoned DCD as soon as ''brain death'' was defined in 1968 and has been late to reintroduce DCD practices.…”

Section: Résumémentioning

confidence: 99%