Donation after cardiac death: The University of Wisconsin experience with renal transplantation

被引:118
作者
Cooper, JT
Chin, LT
Krieger, NR
Fernandez, LA
Foley, DP
Becker, YT
Odorico, JS
Knechtle, SJ
Kalayoglu, M
Sollinger, HW
D'Alessandro, AM [1 ]
机构
[1] Univ Wisconsin, Sch Med, Dept Surg, Madison, WI 53706 USA
[2] Univ Wisconsin, Sch Med, Dept Surg, Madison, WI USA
[3] Tufts Univ, Sch Med, Dept Surg, Boston, MA 02111 USA
[4] Univ Florida, Coll Med, Dept Surg, Gainesville, FL USA
关键词
cardiac death donors; non-heart-beating donors; renal transplantation;
D O I
10.1111/j.1600-6143.2004.00531.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Owing to the shortage of organ donors, there is renewed interest in donation after cardiac death (DCD), formerly referred to as nonheart-beating donation. From January 1984 until August 2000, 382 renal transplants were performed from DCD donors. These were compared with 1089 renal transplants performed from donation after brain death (DBD) donors. The mean warm ischemic time in DCD donors was 16.5 min. There was no statistical difference in cold ischemic time, rate of primary nonfunction, or graft loss in the first 30 days after transplantation. The rate of delayed graft function (DGF) was higher for DCD donors (27.5% vs. 21.3%; p = 0.016) and discharge creatinine was higher in DCD donors (1.92 mg/dL vs. 1.71 mg/dL; p = 0.001). There was no statistical difference in the 5-, 10-, or 15-year allograft survival when DCD donors were compared with DBD donors (64.8%, 44.8%, 27.8% vs. 71.3%, 48.3%, 33.8%; p = 0.054). Likewise, no statistical difference in the rate of technical complications was seen. Our long-term data indicate that the results of renal transplantation from DCD donors are equivalent to long-term allograft survival from DBD donors despite an increase in the rate of DGF. Organ procurement organizations, transplant centers, and hospitals should work to expand the implementation of DCD policies.
引用
收藏
页码:1490 / 1494
页数:5
相关论文
共 12 条
[1]  
Balupuri S, 2000, TRANSPLANTATION, V69, P842
[2]   EXPERIENCE WITH LIVER AND KIDNEY ALLOGRAFTS FROM NON-HEART-BEATING DONORS [J].
CASAVILLA, A ;
RAMIREZ, C ;
SHAPIRO, R ;
NGHIEM, D ;
MIRACLE, K ;
BRONSTHER, O ;
RANDHAWA, P ;
BROZNICK, B ;
FUNG, JJ ;
STARZL, T .
TRANSPLANTATION, 1995, 59 (02) :197-203
[3]   Transplantation of kidneys from donors whose hearts have stopped beating [J].
Cho, YW ;
Terasaki, PI ;
Cecka, JM ;
Gjertson, DW .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (04) :221-225
[4]   Simultaneous pancreas-kidney (SPK) transplantation from controlled non-heart-beating donors (NHBDs) [J].
D'Alessandro, AM ;
Odorico, JS ;
Knechtle, SJ ;
Becker, YT ;
Hoffmann, RM ;
Kalayoglu, M ;
Sollinger, HW .
CELL TRANSPLANTATION, 2000, 9 (06) :889-893
[5]   Liver transplantation from controlled non-heart-beating donors [J].
D'Alessandro, AM ;
Hoffmann, RM ;
Knechtle, SJ ;
Odorico, JS ;
Becker, YT ;
Musat, A ;
Pirsch, JD ;
Sollinger, HW ;
Kalayoglu, M .
SURGERY, 2000, 128 (04) :579-586
[6]  
*I MED DIV HLTH CA, 1997, NONH BEAT ORG TRANSP
[7]  
Kootstra G, 2002, WORLD J SURG, V26, P181
[8]  
Lewis Jonathan, 2003, Prog Transplant, V13, P265
[9]   A comparison of the results of renal transplantation from non-heart-beating, conventional cadaveric, and living donors [J].
Nicholson, ML ;
Metcalfe, MS ;
White, SA ;
Waller, JR ;
Doughman, TM ;
Horsburgh, T ;
Feehally, J ;
Carr, SJ ;
Veitch, PS .
KIDNEY INTERNATIONAL, 2000, 58 (06) :2585-2591
[10]   Renal transplantations performed using non-heart-beating organ donors: Going back to the future? [J].
Rudich, SM ;
Kaplan, B ;
Magee, JC ;
Arenas, JD ;
Punch, JD ;
Kayler, LK ;
Merion, RM ;
Meier-Kriesche, HU .
TRANSPLANTATION, 2002, 74 (12) :1715-1720