6533b854fe1ef96bd12ae154
RESEARCH PRODUCT
Improved short-term outcomes of kidney transplants in controlled donation after the circulatory determination of death with the use of normothermic regional perfusion.
María PadillaMarina Pérez-redondoJosé L. BernalFrancisco CarrizosaÁNgel RuizMaría Luisa Rodríguez-ferreroP. CastroEduardo MiñambresBeatriz Domínguez-gilRafael BadenesCristina Fernández-pérezBelén EstébanezE. OliverJosé M. ManciñoMaría BarberTeresa PontJosé J BlancoAlberto Rodríguez-salgadoRamón LaraJordi ComasCristina VidalDomingo DagaElisabeth CollFernando García-lópezFernando MosteiroAmado AndrésBárbara VidalAna ZapateroCarlos De SantiagoEsperanza Fernández-garcíaLander AtutxaJosé A. MoyaFrancisco J. ElolaDomingo Hernández-marreroChristel TerrónJose María Dueñas-juradosubject
Adultmedicine.medical_specialtyTissue and Organ Procurementdonors and donationdelayed graft function (DGF)graft survivalnephrologyUrologykidney transplantationorgan procurement and allocationRegional perfusion030230 surgery03 medical and health sciences0302 clinical medicineHumansImmunology and AllergyMedicinePharmacology (medical)Retrospective StudiesTransplantationKidneyMachine perfusionorgan perfusion and preservationbusiness.industryGraft SurvivalRetrospective cohort studyOrgan PreservationKidney TransplantationTissue DonorspracticeDelayed Graft FunctionDeathPerfusionmedicine.anatomical_structureclinical researchDonationPropensity score matchingCirculatory systembusinessdonation after circulatory death (DCD)description
Normothermic Regional Perfusion (NRP) allows the in situ perfusion of organs with oxygenated blood in donation after the circulatory determination of death (DCDD). We aimed at evaluating the impact of NRP on the short-term outcomes of kidney transplants in controlled DCDD (cDCDD). This is a multicenter, nationwide, retrospective study comparing cDCDD kidneys obtained with NRP versus the standard rapid recovery (RR) technique. During 2012-2018, 2,302 cDCDD adult kidney transplants were performed in Spain using NRP (n=865) or RR (n=1,437). The study groups differed in donor and recipient age, warm and cold ischemic time and use of ex situ machine perfusion. Transplants in the NRP group were more frequently performed in high-volume centers (=90 transplants/year). Through matching by propensity score, two cohorts with a total of 770 patients were obtained. After the matching, no statistically significant differences were observed between the groups in terms of primary non function (p=0.261) and mortality at one year (p=0.111). However, the RR of kidneys was associated with a significantly increased odds of delayed graft function (OR 1.97 [95%CI 1.43-2.72]; p<0.001) and 1-year graft loss (OR 1.77 [95%CI 1.01-3.17; p=0.034). In conclusion, compared with RR, NRP appears to improve the short-term outcomes of cDCDD kidney transplants.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-01-01 |