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Manso M, Pacheco-Figueiredo L, Antunes-Lopes T, Pina-Vaz T, Oliveira G, Cruz F, Dinis-Oliveira P, Silva J. Kidney transplantation from donation after circulatory death using abdominal normothermic oxygenated circulation: are the outcomes equivalent? Int Urol Nephrol 2021; 53:1355-1359. [PMID: 33721149 DOI: 10.1007/s11255-021-02832-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/06/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To increase the pool of kidneys available for transplantation, a renewed interest in donation after circulatory death (DCD) has emerged. This study aims to determine the outcomes of kidney transplantation from DCD after abdominal normothermic oxygenated circulation (ANOR) support. METHODS From January 2016 to December 2018, 58 kidneys were implanted from uncontrolled DCD after ANOR support. We performed an observational prospective study, assessing graft function and cumulative incidence of surgical complications. A descriptive analysis was conducted. Potential determinants of the outcomes were evaluated, including donor and receptor gender and age, and warm and cold ischemia times. Regression coefficients (β) and odds ratio (OR) were calculated with 95% confidence intervals. A p-value < 0.05 was considered statistically significant. Statistical analysis was accomplished using Stata 11.0 software. RESULTS The median follow-up time was 31.2 months. Delayed graft function (DGF) was evident in 80%, with a mean Cr one month after transplantation of 1.81 mg/dL and 1.33 mg/dL after one year. Primary non-function (PNF) occurred in 5.2% of cases. Male donors were associated with a lower DGF (OR = 0.21, p < 0.05), and a higher donor age was a predictor of poorer graft function at one year (β = - 0.88, p < 0.05). Surgical complications occurred in 31% patients, predominantly vascular. Warm ischemia time superior to 60 min correlated with a higher risk of surgical complications (OR = 11.33, p < 0.05). CONCLUSION Kidney transplantation from DCD is a valuable option, allowing an improvement in the balance between patients waiting for a transplant and the available kidneys.
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Affiliation(s)
- Margarida Manso
- Urology Department, Centro Hospitalar Universitário São João, Alameda Prof. HernaniMonteiro, 4200-319, Porto, Portugal.
- Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Luís Pacheco-Figueiredo
- Urology Department, Centro Hospitalar Universitário São João, Alameda Prof. HernaniMonteiro, 4200-319, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
| | - Tiago Antunes-Lopes
- Urology Department, Centro Hospitalar Universitário São João, Alameda Prof. HernaniMonteiro, 4200-319, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Teresa Pina-Vaz
- Urology Department, Centro Hospitalar Universitário São João, Alameda Prof. HernaniMonteiro, 4200-319, Porto, Portugal
| | - Gerardo Oliveira
- Urology Department, Centro Hospitalar Universitário São João, Alameda Prof. HernaniMonteiro, 4200-319, Porto, Portugal
| | - Francisco Cruz
- Urology Department, Centro Hospitalar Universitário São João, Alameda Prof. HernaniMonteiro, 4200-319, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Paulo Dinis-Oliveira
- Urology Department, Centro Hospitalar Universitário São João, Alameda Prof. HernaniMonteiro, 4200-319, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Silva
- Urology Department, Centro Hospitalar Universitário São João, Alameda Prof. HernaniMonteiro, 4200-319, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
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