scholarly journals The impact of the angioplasty of the renal artery and cold ischemia time in kidney transplantation on graft function

2018 ◽  
Vol 119 (07) ◽  
pp. 416-420
Author(s):  
M. Zavacka ◽  
M. Frankovicova ◽  
J. Pobehova ◽  
P. Zavacky
Keyword(s):  
Kidney Transplantation ◽  
Renal Artery ◽  
Graft Function ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
The Impact

MO942PREDICTORS OF DELAYED GRAFT FUNCTION IN KIDNEY TRANSPLANT RECIPIENTS THROUGHOUT 3 DECADES: A SINGLE-CENTER EXPERIENCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Carolina Figueiredo ◽  
Mariana Fernandes ◽  
Filipe Mira ◽  
Clara Pardinhas ◽  
Rita Leal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Graft Survival ◽  
Univariate Analysis ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Kidney Graft ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
The Impact

Abstract Background and Aims Delayed graft function (DGF), defined as the need for dialysis within one week post-transplantation, is associated with poorer kidney graft survival. We aimed to identify risk factors for DGF throughout 3 decades and evaluate their effect on graft survival. Method Retrospective study including 3081 kidney transplants performed at our transplantation unit between January 1st, 1989 and December 31st, 2018, split in 3 decades (1: 1989-1998; 2: 1999-2008; 3: 2009-2018). Data regarding donor and recipient demographics, time on dialysis, immunization, cold ischemia time, hemodynamic parameters and immunosuppression were collected from our prospectively maintained data base. Results Main donor, recipient and perioperative characteristics are summarized in table 1. There were clear differences in these characteristics between the decades, standing out more adverse features from both recipients and donors. Overall incidence rate of DGF was 16% (n=493): 14% in decade 1; 19.3% in decade 2 and 15% in decade 3. On univariate analysis, most studied variables included in table 1 were statistically significant as predictors of DGF. However, on multivariate analysis, we found that in the first decade the predominant risk factors for DGF were pre-transplant dialysis time and cold-ischemia time, whilst in the following decades donor characteristics, as well as recipient’s weight became more relevant (table 2). Conclusion The observed shift from donor-unrelated variables in the first decade into donor-related variables in the second and third decades as the main determinants of DGF highlights the impact of expanding donor’s acceptance criteria. Nevertheless, the increase in expanded criteria donors did not translate into poorer overall results, probable contributors being shorter cold-ischemia times and stronger immunosuppression.

scholarly journals Multiple Renal Arteries in Kidney Transplantation: Is it a Problem Nowadays?

2018 ◽  
Vol 35 (1-2) ◽  
pp. 39-45
Author(s):  
Joao Carvalho ◽  
Pedro Nunes ◽  
Belmiro Parada ◽  
Edgar Tavares-da-Silva ◽  
Hugo Antunes ◽  
...  
Keyword(s):  
Renal Artery ◽  
Operative Time ◽  
Graft Loss ◽  
Graft Function ◽  
Renal Arteries ◽  
P Value ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
Multiple Renal Arteries

Introduction: Shortage of high quality donors led to an increasing need of compatible organs: grafts with multiple renal arteries (MRA) are one of the solutions, although being a potential risk factor that can impair outcomes. The aim of this study is to provide a view of our experience with multiple renal arteries grafts in renal transplantation and compare the outcome between multiple renal arteries and single renal artery (SRA) groups. Material and Methods: A retrospective study of 2989 kidney transplants was performed in our department between January 1980 and February 2017: demographic characteristics and outcomes were compared between recipients of grafts with multiple renal arteries (648; 21.7%) and single renal artery (2341; 78.3%). Statistical analysis was done using IBM SPSS Statistics 22: chi-square, independent sample t-test and Kaplan Meier tests were used with a p value of 0.05. Results: Grafts from cadaveric donors occurred in 95.8% of the single renal artery group and 97.4% of multiple renal arteries group. The recipients of multiple renal arteries group had a previous higher time on dialysis (50.3 ± 43.1 vs 46.30 ± 37.5 months, p:0.04), a longer operative time (2.43 ± 0.57 vs 2.28 ± 0.49 hours, p<0.001), a higher cold ischemia time (19h08 ± 6h05 vs 18h34 ± 6h17 hours, p:0.04) and more red blood cell transfusions (1.8 ± 0.8 vs 1.7 ± 0.8 packs, p:0.01) than the recipients of single renal artery kidney recipients. In the multiple renal arteries group, ex-vivo bench surgery techniques, in vivo sequential anastomosis and mixed techniques were used. The different options did not affect the outcomes. The rate of delayed graft function, surgical complications, length of hospital stay, acute and chronic rejections, graft loss, death were not statistically different. The follow-up was not statistically different: multiple renal arteries (8 ± 7.3 years) versus single renal artery (7.7 ± 6.6 years) group (p:0.1). The current state of the patient was not dependent on the number of arteries used. Conclusion: Multiple renal arteries grafts were not a problem in our unit: despite of having a longer operative time, higher cold ischemia time and higher blood transfusions rate, short and long-term outcomes were comparable between groups. At this level, literature results are not consensual: prospective studies are necessary.

Effect of Cold Ischemia Time on Kidney Graft Function and Survival: Differences Between Paired Kidney Transplants From the Same Donor

2019 ◽  
Vol 51 (2) ◽  
pp. 321-323 ◽  
Author(s):  
J.L. Pérez-Canga ◽  
L. Martín Penagos ◽  
R. Ballestero Diego ◽  
R. Valero San Cecilio ◽  
E. Rodrigo Calabia ◽  
...  
Keyword(s):  
Graft Function ◽  
Kidney Graft ◽  
Cold Ischemia Time ◽  
Kidney Transplants ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
Survival Differences

Donor Age Amplifies the Detrimental Effects of Cold Ischemia Time on Long-Term Kidney Allograft Survival Independently of the Occurrence of Delayed Graft Function or Early Acute Rejection

2020 ◽  
Vol 18 (4) ◽  
pp. 436-443
Author(s):  
Pedro Rincon Cintra da Cruz ◽  
Aderivaldo Cabral Dias Filho ◽  
Viviane Brandão Bandeira Mello Santana ◽  
Rubia Bethania Biela Boaretto ◽  
Cassio Luis Zanettini Riccetto
Keyword(s):  
Acute Rejection ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Cold Ischemia Time ◽  
Donor Age ◽  
Allograft Survival ◽  
Cold Ischemia ◽  
Kidney Allograft ◽  
Ischemia Time

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.

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