[Functional and economic impact of the use of Wisconsin University conservation solution versus Eurocollins in relation to the period of cold ischemia in renal transplantation of cadaveric donor].
Comparison of the effect of the Wisconsin University (WU) conservation solution in the graft's functional evolution and survival, and its cost-benefit relationship versus the Eurocollins (EC) solution with regard to cold ischaemia duration in a series of 142 consecutive adults renal transplantations from corpse donor, removed with beating heart. Of 142 kidneys, 92 (64.7%) were kept in WU and 50 (35.2%) in EC. Of the WU group, 62 (67.3%) kidneys were transplanted after a cold ischaemia of under 24 hours and 30 (32.6%) after cold ischaemia of more than 24 hours. In the EC group, 23 (46%) were kept in cold ischaemia for an interval shorter than or equal to 24 hours and 27 (54%) for more than 24 hours. Incidence of initial graft dysfunction (IGD) was greater in the EC groups (65% and 78%) versus the WU groups (39% and 50%), the difference being statistically significant (p). The graft function, as indicated by the creatinine levels was always better in the WU groups. There was a decreased need for complementary dialysis sessions, less days of oliguria and shorter hospitalization in the WU groups (p). There were no significant differences in the four series with regard to rejection episodes, cyclosporin-related nephrotoxicity, and vascular and urinary tract complications. All of which turn cost-effective the higher cost per litre of the WU versus the EC solution. Graft survival at 12 and 24 months was also significantly (p) higher for grafts kept in WU. This paper presents the results obtained in the analysis of our transplanted patients. In our experience, the WU solution allows better conservation of renal grafts, with less IGD and better graft survival at 12 and 24 months. These results turn cost-effective the higher cost per litre of the WU versus the EC solution.
Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid.
E
E
Lledó García
C
C
Hernández Fernández
G
G
Escribano Patiño
F
F
Verdú Tartajo
I
I
Moncada Iribarren
F
F
Herranz Amo
R
R
Durán Merino
J M
JM
Díez Cordero
J C
JC
Martín Martínez
J
J
Jara Rascón
D000241:Adenosine / Q000191:economics; D000293:Adolescent; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000191:economics; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005978:Glutathione / Q000191:economics; D006085:Graft Survival; D006801:Humans; D006982:Hypertonic Solutions / Q000191:economics*; D007223:Infant; D007328:Insulin / Q000191:economics; D007511:Ischemia; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000191:economics* / Q000502:physiology*; D008875:Middle Aged; D019188:Organ Preservation Solutions; D011887:Raffinose / Q000191:economics; D015996:Survival Rate; D013997:Time Factors; D014021:Tissue Preservation
C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose
Impacto funcional y económico de la utilización de la solución de conservación de la Universidad de Wisconsis frente Eurocollins en relación al tiempo de isquemia fría en trasplante renal de donante cadáver.