Back to Search
Start Over
Survival and Evolution of Renal Function in Kidney Transplant Recipients From Type II Asystolic Donations: A Single-center Experience.
- Source :
-
Transplantation proceedings [Transplant Proc] 2018 Mar; Vol. 50 (2), pp. 565-568. - Publication Year :
- 2018
-
Abstract
- Background: In recent years, stagnation in the number of kidneys from after brain-dead donors (DBD) has stimulated the use of non-heart beating donors (NHBDs). Herein we present our 5-year experience with type II Maastricht NHBDs in renal transplantation.<br />Methods: All patients (n = 50) in this study received type II Maastricht NHBD kidneys (March 2012 to February 2017), with a median follow-up of 33 months.<br />Results: Mean donor age was 39 ± 12 years, mean creatinine 1.24 ± 0.2 mg/dL, and the most frequently observed blood group (donors and recipients) was type A (64%). Recipients were slightly younger (51 ± 11 years old), with mean time on dialysis of 30 ± 24 months. Almost all were primary transplants. Pre-transplant panel-reactive antibodies (PRA) were <25%; initial immunosuppression was thymoglobulin, corticosteroids, mycophenolate mofetil, and delayed introduction of tacrolimus. Six percent were nonfunctioning kidneys; 79.6% presented with delayed renal function (mean duration 14 ± 9 days). Acute rejection was seen in 6% of patients. Mean creatinine at month 3 was 1.7 ± 0.8 mg/dL, and 1.5 ± 0.8 mg/dL in the first year. The last available mean creatinine was 1.54 ± 0.7 mg/dL. Proteinuria in the third month, first year, and third year was 0.70, 0.41, and 0.26 g/d, respectively. Recipient survival at the first, third, and fifth year was 100%, 100%, and 86%, and when graft-censored for death was 94%, 91%, and 91%, respectively. The incidence of acute rejection during first year was 6%, and 2% in the second year. Exitus incidence was 4% and cytomegalovirus infection was 21.3%. BK viremia between 1000 and 10,000 copies/mL was seen in 4.3%, and reached >10,000 copies/mL in 2.1%.<br />Conclusions: Type II NHBD has shown limited frequency of nonfunctioning kidney and high functional delay. The results in survival and renal function are very acceptable, comparable with levels seen in donation after brain death.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Brain Death
Creatinine blood
Delayed Graft Function epidemiology
Female
Follow-Up Studies
Graft Rejection epidemiology
Graft Survival
Heart Arrest
Humans
Immunosuppression Therapy methods
Incidence
Kidney physiopathology
Male
Middle Aged
Renal Dialysis statistics & numerical data
Transplants physiopathology
Delayed Graft Function etiology
Donor Selection methods
Graft Rejection etiology
Kidney Failure, Chronic therapy
Kidney Transplantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2623
- Volume :
- 50
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 29579853
- Full Text :
- https://doi.org/10.1016/j.transproceed.2017.11.059