title: Normothermic recirculation reduces primary graft dysfunction of kidneys obtained from non-heart-beating donors.
abstract: Our aim was to analyze the short- and long-term function of kidneys procured from non- heartbeating 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.
authors.affiliation: Department of Anaesthesiology, Hospital Clínic de Barcelona, Spain. rvalero@medicina.ub.es
authors.forename: R
authors.initials: R
authors.lastname: Valero
authors.forename: C
authors.initials: C
authors.lastname: Cabrer
authors.forename: F
authors.initials: F
authors.lastname: Oppenheimer
authors.forename: E
authors.initials: E
authors.lastname: Trias
authors.forename: J
authors.initials: J
authors.lastname: Sánchez-Ibáñez
authors.forename: F M
authors.initials: FM
authors.lastname: De Cabo
authors.forename: A
authors.initials: A
authors.lastname: Navarro
authors.forename: D
authors.initials: D
authors.lastname: Paredes
authors.forename: A
authors.initials: A
authors.lastname: Alcaraz
authors.forename: R
authors.initials: R
authors.lastname: Gutiérrez
authors.forename: M
authors.initials: M
authors.lastname: Manyalich
mesh_terms: D000328:Adult; D001831:Body Temperature / Q000502:physiology; D005260:Female; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D006982:Hypertonic Solutions / Q000378:metabolism; D007668:Kidney / Q000098:blood supply* / Q000187:drug effects / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D019188:Organ Preservation Solutions / Q000378:metabolism; D010477:Perfusion; D014019:Tissue Donors / Q000145:classification
chemical_list: C024102:Collins' solution; D006982:Hypertonic Solutions; D019188:Organ Preservation Solutions