Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study

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• dc.contributor.author Portolés, José
• dc.contributor.author Pérez-Sáez, María José
• dc.contributor.author Pascual Santos, Julio
• dc.date.accessioned 2019-06-18T07:48:55Z
• dc.date.available 2019-06-18T07:48:55Z
• dc.date.issued 2019
• dc.description.abstract INTRODUCTION: Many European countries have transplant programmes with controlled donors after cardiac death (cDCD). Twenty-two centres are part of GEODAS group. We analysed clinical results from a nephrological perspective. METHODS: Observational, retrospective and multicentre study with systematic inclusion of all kidney transplant recipients from cDCD, following local protocols regarding extraction and immunosuppression. RESULTS: A total of 335 cDCD donors (mean age 57.2 years) whose deaths were mainly due to cardiovascular events were included. Finally, 566 recipients (mean age 56.5 years; 91.9% first kidney transplant) were analysed with a median of follow-up of 1.9 years. Induction therapy was almost universal (thymoglobulin 67.4%; simulect 32.8%) with maintenance with prednisone-MMF-tacrolimus (91.3%) or combinations with mTOR (6.5%). Mean cold ischaemia time (CIT) was 12.3h. Approximately 3.4% (n=19) of recipients experienced primary non-function, essentially associated with CIT (only CIT ≥ 14 h was associated with primary non-function). Delayed graft function (DGF) was 48.8%. DGF risk factors were CIT ≥ 14 h OR 1.6, previous haemodialysis (vs. peritoneal dialysis) OR 2.1 and donor age OR 1.01 (per year). Twenty-one patients (3.7%) died with a functioning graft, with a recipient and death-censored graft survival at 2-years of 95% and 95.1%, respectively. The estimated glomerular filtration rate at one year of follow-up was 60.9 ml/min. CONCLUSIONS: CIT is a modifiable factor for improving the incidence of primary non-function in kidney transplant arising from cDCD. cDCD kidney transplant recipients have higher delayed graft function rate, but the same patient and graft survival compared to brain-dead donation in historical references. These results are convincing enough to continue fostering this type of donation.
• dc.format.mimetype application/pdf
• dc.identifier.citation Portolés JM, Pérez-Sáez MJ, López-Sánchez P, Lafuente-Covarrubias O, Juega J, Hernández D. et al. Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study. Nefrologia. 2019 Mar - Apr;39(2):151-159. DOI: 10.1016/j.nefro.2018.07.013
• dc.identifier.doi http://dx.doi.org/10.1016/j.nefro.2018.07.013
• dc.identifier.issn 0211-6995
• dc.identifier.uri http://hdl.handle.net/10230/41795
• dc.language.iso eng
• dc.publisher Elsevier
• dc.rights 2013-2514/© 2018 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Clinical outcomes
• dc.subject.keyword Delayed graft function
• dc.subject.keyword Donación tras parada circulatoria controlada
• dc.subject.keyword Donation with controlled donors after circulatory death
• dc.subject.keyword Función retrasada del injerto
• dc.subject.keyword Kidney transplant
• dc.subject.keyword Resultados clínicos
• dc.subject.keyword Trasplante renal
• dc.title Kidney transplant from controlled donors following circulatory death: Results from the GEODAS-3 multicentre study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion