Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death
Uncontrolled donation after circulatory death (uDCD) increases organ availability for kidney transplant (KT) with short-term outcomes similar to those obtained from donation after brain death (DBD) donors. However, heterogeneous results in the long term have been reported. We compared 10-year outcom...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; |
|---|---|
| Format: | Article |
| Publication date: | 2018 |
| Country: | España |
| Institution: | Universidad Complutense de Madrid (UCM) |
| Repository: | Docta Complutense |
| Language: | English |
| OAI Identifier: | oai:docta.ucm.es:20.500.14352/98838 |
| Online Access: | https://hdl.handle.net/20.500.14352/98838 |
| Access Level: | Open access |
| Keyword: | 617 Clinical research / practice Donors and donation: donation after brain death (DBD) Donors and donation: donation after circulatory death (DCD) Extracorporeal membrane oxygenation (ECMO) Graft survival Kidney disease Kidney transplantation / nephrology Cirugía 3213 Cirugía |
| _version_ | 1878732816740515840 |
|---|---|
| author | Molina Martín, María |
| author2 | Guerrero Ramos, Félix Fernández Ruiz, Mario González Monte, Esther Cabrera, Jimena Morales Ruiz, Enrique Gutiérrez Martínez, Eduardo Hernández Martínez, Eduardo Rafael Polanco, Natalia Hernández Vicente, Ana Praga Terente, Manuel Rodríguez Antolín, Alfredo Pamplona Casamayor, Manuel Rosa, Federico de la Cavero, Teresa Chico, Mario Villar, Alicia Justo Alonso, Iago Andrés Belmonte, Amado |
| author2_role | author author author author author author author author author author author author author author author author author author |
| author_browse | Andrés Belmonte, Amado Cabrera, Jimena Cavero, Teresa Chico, Mario Fernández Ruiz, Mario González Monte, Esther Guerrero Ramos, Félix Gutiérrez Martínez, Eduardo Hernández Martínez, Eduardo Rafael Hernández Vicente, Ana Justo Alonso, Iago Molina Martín, María Morales Ruiz, Enrique Pamplona Casamayor, Manuel Polanco, Natalia Praga Terente, Manuel Rodríguez Antolín, Alfredo Rosa, Federico de la Villar, Alicia |
| author_facet | Molina Martín, María Guerrero Ramos, Félix Fernández Ruiz, Mario González Monte, Esther Cabrera, Jimena Morales Ruiz, Enrique Gutiérrez Martínez, Eduardo Hernández Martínez, Eduardo Rafael Polanco, Natalia Hernández Vicente, Ana Praga Terente, Manuel Rodríguez Antolín, Alfredo Pamplona Casamayor, Manuel Rosa, Federico de la Cavero, Teresa Chico, Mario Villar, Alicia Justo Alonso, Iago Andrés Belmonte, Amado |
| author_role | author |
| collection | Docta Complutense |
| description | Uncontrolled donation after circulatory death (uDCD) increases organ availability for kidney transplant (KT) with short-term outcomes similar to those obtained from donation after brain death (DBD) donors. However, heterogeneous results in the long term have been reported. We compared 10-year outcomes between 237 KT recipients from uDCD donors maintained by normothermic extracorporeal membrane oxygenation (nECMO) and 237 patients undergoing KT from standard criteria DBD donors during the same period at our institution. We further analyzed risk factors for death-censored graft survival in the uDCD group. Delayed graft function (DGF) was more common in the uDCD group (73.4% vs 46.4%; P < .01), although glomerular filtration rates at the end of follow-up were similar in the 2 groups. uDCD and DBD groups had similar rates for 10-year death-censored graft (82.1% vs 80.4%; P = .623) and recipient survival (86.2% vs 87.6%; P = .454). Donor age >50 years was associated with graft loss in the uDCD group (hazard ratio: 1.91; P = .058), whereas the occurrence of DGF showed no significant effect. uDCD KT under nECMO support resulted in similar graft function and long-term outcomes compared with KT from standard criteria DBD donors. Increased donor age could negatively affect graft survival after uDCD donation. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_4a5cf6e48b5de468a2a7204ecfa8cda2 |
| institution | Universidad Complutense de Madrid (UCM) |
| instname_str | Universidad Complutense de Madrid (UCM) |
| language | eng |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:docta.ucm.es:20.500.14352/98838 |
| publishDate | 2018 |
| publishDateSort | 2018 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| reponame_str | Docta Complutense |
| spelling | Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death Molina Martín, María Guerrero Ramos, Félix Fernández Ruiz, Mario González Monte, Esther Cabrera, Jimena Morales Ruiz, Enrique Gutiérrez Martínez, Eduardo Hernández Martínez, Eduardo Rafael Polanco, Natalia Hernández Vicente, Ana Praga Terente, Manuel Rodríguez Antolín, Alfredo Pamplona Casamayor, Manuel Rosa, Federico de la Cavero, Teresa Chico, Mario Villar, Alicia Justo Alonso, Iago Andrés Belmonte, Amado 617 Clinical research / practice Donors and donation: donation after brain death (DBD) Donors and donation: donation after circulatory death (DCD) Extracorporeal membrane oxygenation (ECMO) Graft survival Kidney disease Kidney transplantation / nephrology Cirugía 3213 Cirugía Uncontrolled donation after circulatory death (uDCD) increases organ availability for kidney transplant (KT) with short-term outcomes similar to those obtained from donation after brain death (DBD) donors. However, heterogeneous results in the long term have been reported. We compared 10-year outcomes between 237 KT recipients from uDCD donors maintained by normothermic extracorporeal membrane oxygenation (nECMO) and 237 patients undergoing KT from standard criteria DBD donors during the same period at our institution. We further analyzed risk factors for death-censored graft survival in the uDCD group. Delayed graft function (DGF) was more common in the uDCD group (73.4% vs 46.4%; P < .01), although glomerular filtration rates at the end of follow-up were similar in the 2 groups. uDCD and DBD groups had similar rates for 10-year death-censored graft (82.1% vs 80.4%; P = .623) and recipient survival (86.2% vs 87.6%; P = .454). Donor age >50 years was associated with graft loss in the uDCD group (hazard ratio: 1.91; P = .058), whereas the occurrence of DGF showed no significant effect. uDCD KT under nECMO support resulted in similar graft function and long-term outcomes compared with KT from standard criteria DBD donors. Increased donor age could negatively affect graft survival after uDCD donation. Elsevier https://hdl.handle.net/20.500.14352/98838 |
| spellingShingle | Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death Molina Martín, María 617 Clinical research / practice Donors and donation: donation after brain death (DBD) Donors and donation: donation after circulatory death (DCD) Extracorporeal membrane oxygenation (ECMO) Graft survival Kidney disease Kidney transplantation / nephrology Cirugía 3213 Cirugía |
| title | Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death |
| title_full | Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death |
| title_fullStr | Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death |
| title_full_unstemmed | Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death |
| title_short | Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death |
| title_sort | Kidney transplantation from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death |
| topic | 617 Clinical research / practice Donors and donation: donation after brain death (DBD) Donors and donation: donation after circulatory death (DCD) Extracorporeal membrane oxygenation (ECMO) Graft survival Kidney disease Kidney transplantation / nephrology Cirugía 3213 Cirugía |
| topic_facet | 617 Clinical research / practice Donors and donation: donation after brain death (DBD) Donors and donation: donation after circulatory death (DCD) Extracorporeal membrane oxygenation (ECMO) Graft survival Kidney disease Kidney transplantation / nephrology Cirugía 3213 Cirugía |
| url | https://hdl.handle.net/20.500.14352/98838 |