Use of Marginal Donors in Kidney Transplantation: Our Experience

Gambino, G.; Gioviale, Maria Concetta; Maione, C.; Bona, Anna Di; Buffa, D; Virzi, Cristina; Turco, Danilo; Damiano, Giuseppe; Buscemi, Giuseppe; Monte, Attilio Ignazio Lo

doi:10.1016/j.transproceed.2006.02.148

Cited by 8 publications

(5 citation statements)

References 8 publications

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“…The risk of disease transmission through organ transplantation must be balanced against the risk of potential recipients dying while waiting for an organ (23). However, due to organ shortage and because organ transplantation often is lifesaving, organs from donors with known elevated risk including men who have sex with other men (MSM) history often are transplanted whenever the benefit of transplantation is considered to outweigh the risk of potential disease transmission (24)(25)(26)(27)(28). Risk-benefit may not be the same, however, for all organ types, or for all candidates on the waiting list for a given organ type, emphasizing the need for careful candidate informed consent.…”

Section: Discussionmentioning

confidence: 99%

Transmission of Human Immunodeficiency Virus and Hepatitis C Virus From an Organ Donor to Four Transplant Recipients

Ison

Llata

Conover

et al. 2011

American Journal of Transplantation

125

114

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In 2007, a previously uninfected kidney transplant recipient tested positive for human immunodeficiency virus type 1 (HIV) and hepatitis C virus (HCV) infection. Clinical information of the organ donor and the recipients was collected by medical record review. Sera from recipients and donor were tested for serologic and nucleic acid-based markers of HIV and HCV infection, and isolates were compared for genetic relatedness. Routine donor serologic screening for HIV and HCV infection was negative; the donor's only known risk factor for HIV was having sex with another man. Four organs (two kidneys, liver and heart) were transplanted to four recipients. Nucleic acid testing (NAT) of donor sera and posttransplant sera from all recipients were positive for HIV and HCV. HIV nucleotide sequences were indistinguishable between the donor and four recipients, and HCV subgenomic sequences clustered closely together. Two patients subsequently died and the transplanted organs failed in the other two patients. This is the first recognized cotransmission of HIV and HCV from an organ donor to transplant recipients. Routine posttransplant HIV and HCV serological testing and NAT of recipients of organs from donors with suspected risk factors should be considered as routine practice.

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Section: Discussionmentioning

confidence: 99%

Transmission of Human Immunodeficiency Virus and Hepatitis C Virus From an Organ Donor to Four Transplant Recipients

Ison

Llata

Conover

et al. 2011

American Journal of Transplantation

125

114

View full text Add to dashboard Cite

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“…After 240 minutes of storage, exocrine tissue of three groups was separately obtained by whole pancreatic digestion using collagenase P (3 mg/mL; Roche) according to Gray's method. 27 The tissue pellet was underlayed on a discontinuous Ficoll gradient (Sigma Aldrich, Italy) at 1108, 1096, 1069, 1037 g/cm 3 . After 750 g centrifugation at 4°C for 18 minutes we observed 1096/1108 and 1037/1069 layer interfaces of acinar cells and epithelial ductal cells respectively.…”

Section: Culture and Immunostainingmentioning

confidence: 99%

“…To improve these adverse situations requires knowledge concerning ischemic damage inherent to the transplant process. [1][2][3][4][5][6][7] Over the last 10 years we have been exploring techniques for pancreas harvest using in situ perfusion to reduce ischemic injury in small and middle-size animals. Employing in situ perfusion we have increased the amount and quality of purified rat pancreatic exocrine cells compared with collection after exsanguination.…”

mentioning

confidence: 99%

Histologic Effects of University of Wisconsin Two-Layer Method Preservation of Rat Pancreas

Gioviale

Damiano

Puleio

et al. 2013

Transplantation Proceedings

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Marginal donors represent a poorly utilized source of organs for transplantation despite their availability. The key is to reduce the ischemic damage in the effort to improve organ quality. This study investigated the histologic effects after in situ perfusion of preservation with a two-layer method compared with the classic University of Wisconsin preservation in term of tissue integrity and number of viable exocrine cells in the rat pancreas both after exsanguination and at 8 weeks of cryopreservation. Pancreata harvested from 60 rats were collected using 3 methods: two-layer method following University of Wisconsin perfusion; exsanguination; and classic University of Wisconsin perfusion/storage. In addition to histologic analysis of collected pancreata, we analyzed the number of CK19(+) cells and their viability using chi-square tests with values P < .05 considered to be significant. Rat pancreas histology showed as University of Wisconsin in situ perfusion and preservation by the two-layer method to be more effective to maintain the morphologic integrity of both exocrine and endocrine tissues. There were a larger number of CK19(+) cells with good viability. Moreover, the effects of oxygenation were visible in pancreas biopsies preserved after exsanguination. In situ University of Wisconsin perfusion and preservation for 240 minutes with the two-layer method yielded greater numbers and viability of CK19(+) cells even after 8 weeks of cryopreservation.

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“…One of the fields of major interest of researches in organ transplant is currently the recovery of marginal organs—a concept that passes from the reduction of warm ischemia time—by using better perfusion solutions more capable of preserving cell function, and technical stratagems developed for this purpose. The reduction of this unavoidable time is thought to be crucial for graft function, especially with the increased use of marginal donors to encompass a long waiting list for people who need a transplant .…”

mentioning

confidence: 99%

Renal Transplantation by Automatic Anastomotic Device in a Porcine Model

et al. 2015

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Automatic vascular staplers for vascular anastomoses in kidney transplantation may dramatically reduce the operative time and, in particular, warm ischemia time, thus increasing the outcome of transplantation. Ten pigs underwent kidney auto-transplantation by automatic anastomotic device. Kidneys were collected by laparotomy with selective ligations at the renal hilum and perfused with cold storage solution. To overcome the shortage in length of renal hilum, a tract of the internal jugular vein was harvested to increase the length of the vessels. The anastomoses were totally performed by the use of the anastomotic device. On 10 kidney transplants, nine were successful and no complications occurred. Renal resistive indexes showed a slight increase in the immediate postoperative period returning normal at 10 days of follow-up. We demonstrated the possibility to perform renal vascular anastomoses by means of an automatic anastomotic device. This instrument developed for coronary bypass surgery by virtue of the small caliber of the vessels could be adopted on a larger scale for renal transplantation. The reduced warm ischemia time needed for anastomosis may help to achieve a better outcome for the graft and expand the pool of marginal donors in renal transplantation.

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Use of Marginal Donors in Kidney Transplantation: Our Experience

Cited by 8 publications

References 8 publications

Transmission of Human Immunodeficiency Virus and Hepatitis C Virus From an Organ Donor to Four Transplant Recipients

Transmission of Human Immunodeficiency Virus and Hepatitis C Virus From an Organ Donor to Four Transplant Recipients

Histologic Effects of University of Wisconsin Two-Layer Method Preservation of Rat Pancreas

Renal Transplantation by Automatic Anastomotic Device in a Porcine Model

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