Kidney Graft Outcome and Quality (After Transplantation) From Uncontrolled Deceased Donors After Cardiac Arrest |
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| Authors: | W. Hanf R. Codas V. Meas‐Yedid J. Berthiller F. Buron C. Chauvet M. Brunet A. Giroud B. C. McGregor J. C. Olivo‐Marin A. Hadj‐Aissa A. Faure P. Petruzzo X. Martin L. Badet E. Morelon |
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| Affiliation: | 1. Service de Néphrologie, Transplantation et Immunologie Clinique, H?pital Edouard Herriot, Hospices Civils de Lyon, France;2. Service d'Urologie de la Transplantation, H?pital Edouard Herriot, Hospices Civils de Lyon, France;3. Institut Pasteur, Unité d'Analyse d'Image Quantitative, Département de Biologie Cellulaire et Infection, CNRS URA 2582, Paris, France;4. Hospices Civils de Lyon, P?le Information Médicale Evaluation Recherche, Lyon, F‐69424, France;5. Université Lyon 1, Equipe d'Accueil 4129, France;6. Service d'Anatomie et de Cytopathologie Cellulaire, H?pital Edouard Herriot, Hospices Civils de Lyon, France;7. Service D'exploration Rénale Fonctionnelle, H?pital Edouard Herriot, Hospices Civils de Lyon, France;8. Département D'anesthésie et de Réanimation, H?pital Edouard Herriot, Hospices Civils de Lyon, France;9. Université Lyon 1, INSERM U 851, Lyon, France |
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| Abstract: | The use of uncontrolled deceased donors after cardiac arrest (uDDCA) has been developed in France to compensate for organ shortage. The quality of these kidneys remains unclear. We analyzed kidney graft function and histology from 27 uDDCA and compared them with kidneys from 30 extended criteria donors (ECD) and from 24 simultaneous pancreas kidney (SPK) donors as a control group of optimal deceased donors. Kidneys from ECD and SPK donors were preserved by static cold storage while kidneys from uDDCA were preserved by pulsatile perfusion. The uDDCA graft function at 3 years posttransplantation (estimated with MDRD and measured with inulin clearance) did not differ from that of the ECD group (eGFR 44.1 vs. 37.4 mL/min/1.73 m2, p = 0.13; mGFR 44.6 vs. 36.1 mL/min/1.73 m2, p = 0.07 in the uDDCA and ECD groups, respectively). The histological assessment of 3‐month and 1‐year protocol biopsies did not show differences for interstitial lesions between the uDDCA and ECD grafts (IF score at M3 was 30 vs. 28% and at M12 36 vs. 33%, p = NS). In conclusion, the results at 3 years with carefully selected and machine‐perfused uDDCA kidneys have been comparable to ECD kidneys and encourage continuation of this program and development of similar programs. |
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| Keywords: | Deceased donor after cardiac arrest extended criteria donor fibrosis graft function |
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