title: The impact of donor factors on early graft function in kidney transplantation from donation after cardiac death.
abstract: Donation after cardiac death (DCD) has the potential to significantly increase the number of organ donors. In this study, we investigate the influence of several donor parameters on the early graft function in kidney transplantation from DCD donors. We performed 58 kidney transplantations from DCD donors. Recipients were divided into 2 groups according to their graft function: normal graft function (NGF), patients who became be free of hemodialysis within 14 days post-transplantation) and delayed graft function (DGF) group, patients who required hemodialysis for longer than 15 days after transplantation). We compared donor age, sex, cause of death, warm and total ischemic time, duration of anuria (urine volume < 10 mL/h), and low blood pressure (systolic blood pressure < 60 mm Hg), usage of catecholamine and vasopressin, serum creatinine on the day of admission and graft retrieval, serum sodium concentration, and body temperature between 2 groups. The number of recipients in NGF and DGF group was 41 and 17. Univariate analysis revealed that duration of anuria (<24 vs ≥ 24 hours) and usage of catecholamine significantly influenced graft function. Duration of anuria was an independent risk factor for early graft function by multivariate analysis. In cadaveric kidney transplantation from DCD donors, there was a trend to poorer early graft function with donors who suffered from anuria for longer than 24 hours before kidney retrieval.
authors.affiliation: Department of Urology, Kobe University, Kobe, Hyogo, Japan. Electronic address: stonevil@med.kobe-u.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Ishimura
authors.affiliation: Department of Urology, Kobe University, Kobe, Hyogo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Muramaki
authors.affiliation: Department of Urology, Hyogo Prefectural Nishinomiya Hospital, Kobe, Hyogo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kishikawa
authors.affiliation: Department of Urology, Kobe University, Kobe, Hyogo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Department of Urology, Kobe University, Kobe, Hyogo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Hyogo Prefectural Nishinomiya Hospital, Kobe, Hyogo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Department of Urology, Hyogo Medical College, Kobe, Hyogo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nojima
authors.affiliation: Department of Urology, Hyogo Medical College, Kobe, Hyogo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Joyoejiri Hospital, Kobe, Hyogo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ichikawa
authors.affiliation: Department of Urology, Kobe University, Kobe, Hyogo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000328:Adult; D000368:Aged; D001002:Anuria / Q000150:complications; D002395:Catecholamines / Q000627:therapeutic use; D051799:Delayed Graft Function / Q000209:etiology / Q000628:therapy; D046148:Donor Selection; D005260:Female; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines