Long-term Results of Renal Transplantation Using Kidneys Harvested From Non-Heartbeating Donors: A 15-Year Experience

Droupy, S.; Blanchet, Pascal; Eschwège, P.; Hammoudi, Y.; Joseph, Liliane; Kriaa, F; Bédossa, Pierre; Duranteau, Jacques; Charpentier, B; Galand, Benoît

doi:10.1016/s0022-5347(05)64027-x

Cited by 17 publications

(5 citation statements)

References 17 publications

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“…US and UL rates in DCD KT are scattered in the literature (3.5-15%) (5,6) and our rate was comparable to these results (12.6%). However, perigraft collection rate in our study (urinary leak and lymphocele) was 12.6%, notably lower than another recent Spanish study (30.8%) (7).…”

Section: Discussionsupporting

confidence: 87%

What Donation Features are Related to Complications in Donation after Circulatory Death Kidney Transplant? Analysis of Risk Factors for Complication after Circulatory Death Kidney Transplant

Coello

Martínez

Peraire

et al. 2022

Archivos Españoles de Urología

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Objective: Complications in donation after circulatory death (DCD) kidney transplants (KT) are barely described, while in some urological complications the cause is unknown. The aim of this study is to describe surgical and urological complications and analyze what donation features could be involved. Methods: A prospective, single center study was performed from 2016 to 2019 including all KT from controlled cardiac death donors (cDCD). Results: A total of 86 cDCD KT were included in the study. Recipient BMI, residual urine output (RUO) <500 mL/day, delayed graft function (DGF), and wound complication were related to UTI (p = 0.020, p = 0.008, p = 0.016, and p = 0.004, respectively). Features related to early graft nephrectomy were recipient BMI and recipients with diabetes mellitus (DM) (p = 0.025 and p = 0.036, respectively). DM in recipients was significantly associated with hematuria (p = 0.046). Urinary leak (UL) was associated to vascular complication and ureteral stricture (US) (p = 0.029 both). UL and lymphocele were associated to US (p = 0.029 both). Features related to lymphocele were recipient BMI and US (p = 0.028 and p = 0.029, respectively). History of previous transplant, time from cardiac arrest (CA) to cold flush, and DGF, were associated to wound complication (p = 0.040, p = 0.011 and p = 0.016, respectively).Conclusions: Surgical and urological complications after KT are an important issue to resolve. Our data revealed an association between RUO <500 mL/day, DGF, and wound complication with urinary infection, as well as between recipient DM and hematuria. Recipient BMI and DM were related to early graft nephrectomy. Vascular complications were associated with urinary leak, and lymphocele with US. Finally, wound complication was related to previous transplant, DGF, and time from CA to cold flush. This data revealed interesting associations between donor and recipient features and cDCD KT complications, providing more information to improve prevention and management.

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Section: Discussionsupporting

confidence: 87%

What Donation Features are Related to Complications in Donation after Circulatory Death Kidney Transplant? Analysis of Risk Factors for Complication after Circulatory Death Kidney Transplant

Coello

Martínez

Peraire

et al. 2022

Archivos Españoles de Urología

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“…Therefore, adequate management of these suboptimal donors is critical. 15,16,[28][29][30][31][32] Time is of the essence in brain death donors because of myocardial dysfunction, vasoplegia, and diabetes insipides, all of which lead to highly unstable hemodynamics and impart a high risk for acute renal failure and cardiac arrest before organ removal. 15,16 Although acute tubular necrosis, a process that is often sustained during the procurement and storing of the graft, is reversible, it often leads to delayed graft function and decreases long-term graft survival.…”

Section: Discussionmentioning

confidence: 99%

The use of contrast media in deceased kidney donors does not affect initial graft function or graft survival

Vigneau

Fulgencio

Godier

et al. 2006

Kidney International

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Patients receiving cadaveric kidney transplants often experience delayed graft function. As iodinated contrast media injection (ICMI), necessary for cerebral angiography, which is often used to diagnose brain death, can be nephrotoxic, we compared renal function recovery (RFR) and 1-year and long-term graft survival according to the method used to diagnose brain death. Data from 9921 cadaveric kidneys, transplanted between 1 January 1998 and 31 December 2003, were retrieved from the French National Registry for organ donation. We defined RFR as the number of days for the recipient to reach a plasma creatinine less than 250 mumol/l, and/or a 24-h urine output greater than 1000 ml. RFR and 1-year and long-term graft survival were compared between four different donor groups (according to ICMI and diabetes mellitus). A total of 41.5% of deceased donors received ICMI before organ procurement and 1.95% of them were diabetic. History of ICMI or diabetes in the donor did not influence RFR or 1-year graft survival. Long-term graft survival was decreased in the group of patients transplanted with a diabetic graft as compared to patients transplanted with a non-diabetic graft (P=0.001). History of ICMI in the donor did not affect long-term graft survival in the non-diabetic donor group (P=0.2); however, in the diabetic group, ICMI tended to decrease long-term graft survival (P=0.056). ICMI did not affect RFR or graft survival in non-diabetic deceased donors. However, its use in diabetic deceased donors requires further study.

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“…from a gunshot wound). Despite increased rates of delayed graft function, the graft and patient survival rates for donation after cardiac death (DCD) kidneys-both controlled DCD and ROR-are indistinguishable from standard deceased donor kidneys (5)(6)(7).…”

mentioning

confidence: 99%

Is Rapid Organ Recovery a Good Idea? An Exploratory Study of the Public’s Knowledge and Attitudes

DuBois

Waterman

Iltis

et al. 2009

American Journal of Transplantation

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In 2006, the Institute of Medicine (IOM) recommended demonstration projects on uncontrolled donation after cardiac death or rapid organ recovery (ROR). To investigate what the public thinks about key ethical and policy questions associated with ROR, 70 AfricanAmerican, Caucasian and Latino community members in St. Louis, MO, participated in focus groups and completed surveys, before and after being educated about ROR. Before the focus group, most participants believed mistakenly that they could donate organs following an unexpected cardiac arrest (76%). After the focus group, 84% would want to donate organs after unexpected cardiac arrest; 81% would support organ cooling to enable this. The public generally supported organ cooling without family consent if the individual had joined the donor registry, but were mixed in their opinions about what should be done if they were not on the registry. African-American and Latino participants expressed greater fears than Caucasians that if they consented to organ donation, physicians might do less to save their life; however, support for ROR was not significantly lower in these subgroups. Although this study is exploratory, public support for ROR was present. We recommend that adequate consent processes and safeguards be established to foster trust and support for ROR.

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Long-term Results of Renal Transplantation Using Kidneys Harvested From Non-Heartbeating Donors: A 15-Year Experience

Cited by 17 publications

References 17 publications

What Donation Features are Related to Complications in Donation after Circulatory Death Kidney Transplant? Analysis of Risk Factors for Complication after Circulatory Death Kidney Transplant

What Donation Features are Related to Complications in Donation after Circulatory Death Kidney Transplant? Analysis of Risk Factors for Complication after Circulatory Death Kidney Transplant

The use of contrast media in deceased kidney donors does not affect initial graft function or graft survival

Is Rapid Organ Recovery a Good Idea? An Exploratory Study of the Public’s Knowledge and Attitudes

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