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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Nephrology 1/2018

Uncontrolled donation after circulatory death: comparison of two kidney preservation protocols on graft outcomes

Zeitschrift:
BMC Nephrology > Ausgabe 1/2018
Autoren:
Claire Delsuc, Alexandre Faure, Julien Berthiller, Didier Dorez, Xavier Matillon, Vannary Meas-Yedid, Bernard Floccard, Guillaume Marcotte, Vanessa Labeye, Maud Rabeyrin, Ricardo Codas, Cécile Chauvet, Philip Robinson, Emmanuel Morelon, Lionel Badet, William Hanf, Thomas Rimmelé
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12882-017-0805-1) contains supplementary material, which is available to authorized users.

Abstract

Background

Kidney transplantation following uncontrolled donation after circulatory death (uDCD) presents a high risk of delayed graft function due to prolonged warm ischemia time. In order to minimise the effects of ischemia/reperfusion injury during warm ischemia, normothermic recirculation recently replaced in situ perfusion prior to implantation in several institutions. The aim of this study was to compare these preservation methods on kidney graft outcomes.

Methods

The primary endpoint was the one-year measured graft filtration rate (mGFR). We collected retrospective data from 64 consecutive uDCD recipients transplanted over a seven-year period in a single centre.

Results

Thirty-two grafts were preserved by in situ perfusion and 32 by normothermic recirculation. The mean ± SD mGFR at 1 year post-transplantation was 43.0 ± 12.8 mL/min/1.73 m2 in the in situ perfusion group and 53.2 ± 12.8 mL/min/1.73 m2 in the normothermic recirculation group (p = 0.01). Estimated GFR levels were significantly higher in the normothermic recirculation group at 12 months (p = 0.01) and 24 months (p = 0.03) of follow-up. We did not find any difference between groups regarding patient and graft survival, delayed graft function, graft rejection, or interstitial fibrosis.

Conclusions

Function of grafts preserved by normothermic recirculation was better at 1 year and the results suggest that this persists at 2 years, although no difference was found in short-term outcomes. Despite the retrospective design, this study provides an additional argument in favour of normothermic recirculation.
Zusatzmaterial
Additional file 1: Multivariate analysis for one-year mGFR. Comparison between NR and ISP groups with MANOVA analysis adjusting for age, gender, cold ischemia time and NR/ISP duration. (DOCX 48 kb)
12882_2017_805_MOESM1_ESM.docx
Literatur
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