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Pulsatile perfusion reduces the incidence of delayed graft function in expanded criteria donor kidney transplantation.

Abstract
The use of expanded criteria donors (ECD) has been proposed to help combat the discrepancy between organ availability and need. ECD kidneys are associated with delayed graft function (DGF) and worse long-term survival. The aim of this study is to evaluate the impact of pulsatile perfusion (PP) on DGF and graft survival in transplanted ECD kidneys. From January 2000 to December 2003, 4618 ECD kidney-alone transplants were reported to the United Network for Organ Sharing. PP was performed on 912 renal allografts. The prognostic factors of DGF were analyzed using multivariate logistic regression analysis. Risk factors for reduced allograft viability were greater in donors and recipients of PP kidneys. Three-year graft survival of ECD kidneys preserved with PP was similar to cold storage (CS) kidneys. The incidence of DGF in PP kidneys was significantly lower than CS kidneys (26% vs. 36%, p < 0.001). Despite having a greater number of risk factors for reduced graft viability, the ECD-PP kidneys had similar graft survival compared to ECD-CS kidneys. The use of PP, by decreasing the incidence of DGF, may possibly lead to lower overall costs and increased utilization of donor kidneys.
AuthorsL Matsuoka, T Shah, S Aswad, S Bunnapradist, Y Cho, R G Mendez, R Mendez, R Selby
JournalAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 6 Issue 6 Pg. 1473-8 (Jun 2006) ISSN: 1600-6135 [Print] United States
PMID16686773 (Publication Type: Journal Article, Multicenter Study)
Topics
  • Graft Survival (physiology)
  • Humans
  • Kidney Transplantation (mortality, physiology)
  • Living Donors (statistics & numerical data)
  • Middle Aged
  • Patient Selection
  • Perfusion (methods)
  • Regression Analysis
  • Survival Analysis
  • Tissue Donors (statistics & numerical data, supply & distribution)
  • Tissue and Organ Procurement (organization & administration)
  • Treatment Outcome
  • United States

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