دورية أكاديمية
أعرض في EDS

Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation.

التفاصيل البيبلوغرافية
العنوان: Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation.
المؤلفون: Schaapherder A; Department of Transplant Surgery, Leiden University Medical Center, Leiden, the Netherlands., Wijermars LGM; Department of Transplant Surgery, Leiden University Medical Center, Leiden, the Netherlands., de Vries DK; Department of Transplant Surgery, Leiden University Medical Center, Leiden, the Netherlands., de Vries APJ; Department of Medicine, Division of Nephrology, Leiden University Medical Center, Leiden, the Netherlands., Bemelman FJ; Department of Nephrology, Academic Medical Center, Amsterdam, the Netherlands., van de Wetering J; Department of Nephrology, Erasmus University Medical Center Rotterdam, the Netherlands., van Zuilen AD; Department of Nephrology, University Medical Center Utrecht, the Netherlands., Christiaans MHL; Department of Nephrology, Maastricht University Medical Center, the Netherlands., Hilbrands LH; Department of Nephrology, Radboud University Medical Center, the Netherlands., Baas MC; Department of Nephrology, Radboud University Medical Center, the Netherlands., Nurmohamed AS; Department of Nephrology, VU Medical Center, the Netherlands., Berger SP; Department of Nephrology, University Medical Center Groningen, the Netherlands., Alwayn IP; Department of Transplant Surgery, Leiden University Medical Center, Leiden, the Netherlands., Bastiaannet E; Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands., Lindeman JHN; Department of Transplant Surgery, Leiden University Medical Center, Leiden, the Netherlands.
المصدر: EClinicalMedicine [EClinicalMedicine] 2018 Oct 09; Vol. 4-5, pp. 25-31. Date of Electronic Publication: 2018 Oct 09 (Print Publication: 2018).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: The Lancet Country of Publication: England NLM ID: 101733727 Publication Model: eCollection Cited Medium: Internet ISSN: 2589-5370 (Electronic) Linking ISSN: 25895370 NLM ISO Abbreviation: EClinicalMedicine Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [London] : The Lancet, [2018]-
مستخلص: Background: Despite growing waiting lists for renal transplants, hesitations persist with regard to the use of deceased after cardiac death (DCD) renal grafts. We evaluated the outcomes of DCD donations in The Netherlands, the country with the highest proportion of DCD procedures (42.9%) to test whether these hesitations are justified.
Methods: This study included all procedures with grafts donated after brain death (DBD) (n = 3611) and cardiac death (n = 2711) performed between 2000 and 2017. Transplant outcomes were compared by Kaplan Meier and Cox regression analysis, and factors associated with short (within 90 days of transplantation) and long-term graft loss evaluated in multi-variable analyses.
Findings: Despite higher incidences of early graft loss (+ 50%) and delayed graft function (+ 250%) in DCD grafts, 10-year graft and recipient survival were similar for the two graft types (Combined 10-year graft survival: 73.9% (95% CI: 72.5-75.2), combined recipient survival: 64.5% (95 CI: 63.0-66.0%)). Long-term outcome equivalence was explained by a reduced impact of delayed graft function on DCD graft survival (RR: 0.69 (95% CI: 0.55-0.87), p < 0.001). Mid and long-term graft function (eGFR), and the impact of incident delayed graft function on eGFR were similar for DBD and DCD grafts.
Interpretation: Mid and long term outcomes for DCD grafts are equivalent to DBD kidneys. Poorer short term outcomes are offset by a lesser impact of delayed graft function on DCD graft survival. This nation-wide evaluation does not justify the reluctance to use of DCD renal grafts. A strong focus on short-term outcome neglects the superior recovery potential of DCD grafts.
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فهرسة مساهمة: Keywords: Delayed graft function; Donation after brain death; Donation after cardiac death; Graft survival; Kidney transplantation; Outcome
تواريخ الأحداث: Date Created: 20190614 Latest Revision: 20220408
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC6537547
DOI: 10.1016/j.eclinm.2018.09.007
PMID: 31193600
قاعدة البيانات: MEDLINE
الوصف
تدمد:2589-5370
DOI:10.1016/j.eclinm.2018.09.007