Normothermic recirculation reduces primary graft dysfunction of kidneys obtained from non-heart-beating donors |
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Authors: | R. Valero Catiana Cabrer Frederic Oppenheimer Esteve Trias Jacinto Sánchez-Ibáñez Francisco M. De Cabo Aurora Navarro David Paredes Antonio Alcaraz Rafael Gutiérrez Martí Manyalich |
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Affiliation: | (1) Department of Anaesthesiology, Hospital Clínic de Barcelona, Villarroel 170, 08 036 Barcelona, Spain e-mail: rvalero@ medicina.ub.es Fax: + 34-93-2 27-54 09 Tel.: + 34-93-2 27-55 00, ES;(2) Department of Transplant Coordination, Hospital Clínic de Barcelona, Villarroel 170, 08 036 Barcelona, Spain, ES;(3) Department of Urology, Hospital Clínic de Barcelona, Villarroel 170, 08 036 Barcelona, Spain, ES |
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Abstract: | Our aim was to analyze the short- and long-term function of kidneys procured from non- heart-beating donors (NHBD) by means of three techniques: in situ perfusion (ISP), total body cooling (TBC) and normothermic recirculation (NR). Fifty-seven potential NHBD were included. Mean warm ischemia time was 68.9 ± 35.6 min. Forty-four kidneys were obtained from donors perfused with ISP, 8 with TBC, and 8 with NR. Eighteen kidneys (32 %) started functioning immediately, 29 (52 %) showed delayed graft function (DGF) and 9 (16 %) showed primary non function (PNF). The actuarial graft survival rate was 76.4 % at 1 year and 56 % at 5 years. The patient survival rate was 89.3 % at 5 years. Incidence of DGF and PNF was significantly lower in kidneys perfused with NR than those with ISP or TBC (P < 0.01). Duration of DGF was shorter in kidneys obtained through TBC than in kidneys obtained with ISP (P < 0.05). In conclusion, NR reduces the incidence of DGF and may be considered the method of choice for kidney procurement from NHBD. Received: 21 July 1999 Revised: 11 January 2000 Accepted: 5 May 2000 |
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Keywords: | Non-heart-beating donors Kidney transplantation Delayed graft function Normothermic recirculation |
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