scholarly journals New Factors Predicting Delayed Graft Function: a Multi-Center Cohort Study of Kidney Donation After Brain Death Followed by Circulatory Death

2018 ◽  
Vol 43 (3) ◽  
pp. 893-903 ◽  
Author(s):  
Qipeng Sun ◽  
Zhengyu Huang ◽  
Honglan Zhou ◽  
Minzhuan Lin ◽  
Xuefeng Hua ◽  
...  
Keyword(s):  
Cohort Study ◽  
Brain Death ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Kidney Donation ◽  
Donation After Brain Death ◽  
Circulatory Death

scholarly journals Donor Death Category Is an Effect Modifier Between Cold Ischemia Time and Post-transplant Graft Function in Deceased-Donor Kidney Transplant Recipients

2021 ◽  
Vol 8 ◽  
Author(s):  
You Luo ◽  
Zhanwen Dong ◽  
Xiao Hu ◽  
Zuofu Tang ◽  
Jinhua Zhang ◽  
...  
Keyword(s):  
Brain Death ◽  
Graft Function ◽  
Potential Effect ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Effect Modifier ◽  
Ischemia Time ◽  
Post Transplant ◽  
Donation After Brain Death ◽  
Circulatory Death

Objectives: We aimed to analyze the effect of cold ischemia time (CIT) on post-transplant graft function through mixed-effect model analysis to reduce the bias caused by paired mate kidneys.Methods: We reviewed all kidney transplantation records from 2015 to 2019 at our center. After applying the exclusion criteria, 561 cases were included for analysis. All donor characteristics, preservation and matching information, and recipient characteristics were collected. Transplant outcomes included delayed graft function (DGF) and estimated glomerular filtration rate (eGFR). Generalized linear mixed models were applied for analysis. We also explored potential effect modifiers, namely, donor death category, expanded criteria donors, and donor death causes.Results: Among the 561 cases, 79 DGF recipients developed DGF, and 15 recipients who died after surgery were excluded from the eGFR estimation. The median stable eGFR of the 546 recipients was 60.39 (47.63, 76.97) ml/min/1.73 m2. After adjusting for confounding covariates, CIT had a negative impact on DGF incidence [odds ratio = 1.149 (1.006, 1.313), P = 0.041]. In the evaluation of the impact on eGFR, the regression showed that CIT had no significant correlation with eGFR [β = −0.287 (−0.625, 0.051), P = 0.096]. When exploring potential effect modifiers, only the death category showed a significant interaction with CIT in the effect on eGFR (Pinteraction = 0.027). In the donation after brain death (DBD) group, CIT had no significant effect on eGFR [β = 0.135 (−0.433, 0.702), P = 0.642]. In the donation after circulatory death/donation after brain death followed by circulatory death (DCD/DBCD) group, CIT had a significantly negative effect on eGFR [β= −0.700 (−1.196, −0.204), P = 0.006]. Compared to a CIT of 0–6 h, a CIT of 6–8 or 8–12 h did not decrease the post-transplant eGFR. CIT over 12 h (12–16 h or over 16 h) significantly decreased eGFR. With the increase in CIT, the regenerated eGFR worsened (Ptrend = 0.011).Conclusion: Considering the effect of paired mate kidneys, the risk of DGF increased with prolonged CIT. The donor death category was an effect modifier between CIT and eGFR. Prolonged CIT did not reduce the eGFR level in recipients from DBDs but significantly decreased the eGFR in recipients from DCDs/DBCDs. This result indicates the potential biological interaction between CIT and donor death category.

Crystalloid fluids and delayed graft function in kidney transplant: A cohort study

2022 ◽  
Vol 16 (1) ◽  
pp. 38
Author(s):  
Amel Fayed ◽  
Amr ALKouny ◽  
MohammedK ALHarbi ◽  
AbdulrahmanR ALTheaby ◽  
Ghaleb Aboalsamh
Keyword(s):  
Cohort Study ◽  
Kidney Transplant ◽  
Graft Function ◽  
Delayed Graft Function

Donation after Brain Death versus Donation after Circulatory Death: Lung Donor Management Issues

2018 ◽  
Vol 39 (02) ◽  
pp. 138-147 ◽  
Author(s):  
Bronwyn Levvey ◽  
Kovi Levin ◽  
Miranda Paraskeva ◽  
Glen Westall ◽  
Gregory Snell
Keyword(s):  
Brain Death ◽  
Ex Vivo ◽  
Scoring Systems ◽  
Donation After Circulatory Death ◽  
Donor Pool ◽  
Ex Vivo Lung Perfusion ◽  
Conversion Rates ◽  
Donor Lung ◽  
Donation After Brain Death ◽  
Circulatory Death

AbstractLung transplantation (LTx) has traditionally been limited by a lack of suitable donor lungs. With the recognition that lungs are more robust than initially thought, the size of the donor pool of available lungs has increased dramatically in the past decade. Donation after brain death (DBD) and donation after circulatory death (DCD) lungs, both ideal and extended are now routinely utilized. DBD lungs can be damaged. There are important differences in the public's understanding, legal and consent processes, intensive care unit strategies, lung pathophysiology, logistics, and potential-to-actual donor conversion rates between DBD and DCD. Notwithstanding, the short- and long-term outcomes of LTx from any of these DBD versus DCD donor scenarios are now similar, robust, and continue to improve. Large audits suggest there remains a large untapped pool of DCD (but not DBD) lungs that may yet further dramatically increase lung transplant numbers. Donor scoring systems that might predict the donor conversion rates and lung quality, the role of ex vivo lung perfusion as an assessment and lung resuscitation tool, as well as the potential of donor lung quality biomarkers all have immense promise for the clinical field.

scholarly journals The Neglectable Impact of Delayed Graft Function on Long-term Graft Survival in Kidneys Donated After Circulatory Death Associates With Superior Organ Resilience

2019 ◽  
Vol 270 (5) ◽  
pp. 877-883 ◽  
Author(s):  
Michèle J. de Kok ◽  
Dagmara McGuinness ◽  
Paul G. Shiels ◽  
Dorottya K. de Vries ◽  
Joanne B. Tutein Nolthenius ◽  
...  
Keyword(s):  
Graft Survival ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Circulatory Death
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