Renal transplantation from non—heart-beating donors: opportunities and challenges

Nicholson, Michael L.

doi:10.1016/s0955-470x(00)80007-5

Cited by 10 publications

(4 citation statements)

References 88 publications

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“…the donor must be dead by cardiac criteria at the time of retrieval). This became relevant when a decision is taken to discontinue life support measures in a patient who does not meet the criteria for brain-stem death and raises the question of when death should be pronounced after cardiac arrest 12.…”

Section: Ethics and Legal Issuesmentioning

confidence: 99%

Non Heart-Beating Donors in England

Chaib

2008

Clinics

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Chaib E. Non heart-beating-donors in England. Clinics. 2008;63(1):121-34. When transplantation started all organs were retrieved from patients immediately after cardio-respiratory arrest, i.e. from nonheart-beating donors. After the recognition that death resulted from irreversible damage to the brainstem, organ retrieval rapidly switched to patients certified dead after brainstem testing. These heart-beating-donors have become the principal source of organs for transplantation for the last 30 years. The number of heart-beating-donors are declining and this is likely to continue, therefore cadaveric organs from non-heart-beating donor offers a large potential of resources for organ transplantation. The aim of this study is to examine clinical outcomes of non-heart-beating donors in the past 10 years in the UK as an way of decreasing pressure in the huge waiting list for organs transplantation. KEYWORDS:Transplantation. Liver. Kidney. Donors.The imbalance between supply of organs for transplantation and demand for them is widening all over the world. In the United Kingdom (UK) the figures are not different, by the end of December 2004 there were over 6000 people on the active waiting list for organ transplantation. Recent data suggest that over 400 of these people will die each year before a new organ becomes available.

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Section: Ethics and Legal Issuesmentioning

confidence: 99%

Non Heart-Beating Donors in England

Chaib

2008

Clinics

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“…There is a paucity of data relating to the development of CAN in NHBD transplants. The reported rates range widely from 8 to 25 per cent but do not appear to exceed the rates associated with HBD kidney transplants22. A comparative study of NHBD and HBD kidneys matched for a number of risk factors showed that there was no difference in allograft failures due to chronic rejection23.…”

Section: Discussionmentioning

confidence: 95%

Comparison of renal allograft fibrosis after transplantation from heart-beating and non-heart-beating donors

Bains

Sandford

Brook

et al. 2005

Journal of British Surgery

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“…Итак, основной проблемой современной трансплантации почек является изменение нозологического профиля посмертных доноров почек, основными из которых стали пациенты, умершие в результате сосудистых катастроф. Проблема предупреждения и лекарственной коррекции ИКН-нефротоксичности становится особенно актуальной в связи с постоянно возрастающим дефицитом донор- 1,2 ских органов и все более частым использованием в клинической практике почек, полученных от доноров с расширенными критериями (ДРК) -expanded criteria donors [14][15][16][17]. Так, в Санкт-Петербурге в период с 2013-го по 2015 г. доля доноров, причиной смерти которых стали сосудистые заболевания, увеличилась до 82%.…”

Section: Introductionunclassified

“…В этом контексте рассматриваются ингибиторы мишени рапамицина у млекопитающих (mTOR) [32]. Применение mTOR-ингибиторов позволяет снизить уровень циклоспорина в крови, снижая, таким образом, нефротоксичность без ущерба для общей эффективности иммуносупрессии [17,[33][34][35][36][37][38].…”

Section: Introductionunclassified

First Experience in Systemic Administration of Everolimus in Renal Transplantation From Expanded Criteria Donors in Russian Federation

Ульянкина

Скворцов

Ананьев

et al. 2017

RJTAO

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Introduction. Kidney transplant (KTx) with reduced functional reserve is more sensitive to the toxic effects of calcineurin inhibitors (CNI). Immunosuppressive therapy (IST) approach with m-TOR inhibitors in case of KTx from expanded criteria donors (ECD) leads to decreasing levels of cyclosporine (CsA) in the blood. Despite the presence of international pilot studies we do not have yet clear recommendation as to combination of CsA and Everolimus. In this article, we presented 5-year results of the fi rst Russian experience of systematic administration of Everolimus as a basic IST in KTx from ECDs.Materials and methods.The group of recipients (n = 41) having received bilateral kidney transplants from the same ECDs was analyzed. Comparison group (n = 19) received standard IST consisting of CsA, MMF and steroids. Study group included 22 recipients who received kidneys from the same ECDs and IST based on early (starting from the 90th day after transplantation) conversion from MMF to Everolimus – 1.5 mg/day (target concentration – 3–6 ng/mL). Simultaneously with the administration of Everolimus, dosing of Neoral dropped immediately by 50%, and then, in accordance with the target concentration (C0 30–50 ng/mL). Dosage of steroids in patients of the study group was gradually minimized.Results.Both groups were comparable in terms of serum creatinine level and glomerular fi ltration rate (GFR) up to 3 months after transplantation. As a result of the introduction of a new IST scheme in the study group, serum creatinine level in 60 months after KTx was 149.27 ± 42.68 μmol/L, in the comparison group – 209.87 ± 39.56 μmol/L; р < 0.05. In the control group GFR reduced to 27.50 ± 7.39 mL/min/1.73 m2, in the study group it was 46.21 ± 15.17 mL/min/1.73 m2, p < 0.05.Conclusion.Early administration of Everolimus is strongly recommended in all cases of ECD KTx. This approach helps minimize CNI nephrotoxicity, provides the prevention of chronic allograft nephropathy, enables the stable renal function, and contributes to the survival of renal transplant recipients.

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Renal transplantation from non—heart-beating donors: opportunities and challenges

Cited by 10 publications

References 88 publications

Non Heart-Beating Donors in England

Non Heart-Beating Donors in England

Comparison of renal allograft fibrosis after transplantation from heart-beating and non-heart-beating donors

First Experience in Systemic Administration of Everolimus in Renal Transplantation From Expanded Criteria Donors in Russian Federation

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