Improved short-term outcomes of kidney transplants in controlled donation after the circulatory determination of death with the use of normothermic regional perfusion.
clinical research / practice
delayed graft function (DGF)
donors and donation: donation after circulatory death (DCD)
graft survival
kidney transplantation / nephrology
organ perfusion and preservation
organ procurement and allocation
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
revised:
26
03
2021
received:
18
12
2020
accepted:
16
04
2021
pubmed:
24
4
2021
medline:
12
11
2021
entrez:
23
4
2021
Statut:
ppublish
Résumé
Normothermic regional perfusion (NRP) allows the in situ perfusion of organs with oxygenated blood in donation after the circulatory determination of death (DCDD). We aimed at evaluating the impact of NRP on the short-term outcomes of kidney transplants in controlled DCDD (cDCDD). This is a multicenter, nationwide, retrospective study comparing cDCDD kidneys obtained with NRP versus the standard rapid recovery (RR) technique. During 2012-2018, 2302 cDCDD adult kidney transplants were performed in Spain using NRP (n = 865) or RR (n = 1437). The study groups differed in donor and recipient age, warm, and cold ischemic time and use of ex situ machine perfusion. Transplants in the NRP group were more frequently performed in high-volume centers (≥90 transplants/year). Through matching by propensity score, two cohorts with a total of 770 patients were obtained. After the matching, no statistically significant differences were observed between the groups in terms of primary nonfunction (p = .261) and mortality at 1 year (p = .111). However, the RR of kidneys was associated with a significantly increased odds of delayed graft function (OR 1.97 [95% CI 1.43-2.72]; p < .001) and 1-year graft loss (OR 1.77 [95% CI 1.01-3.17]; p = .034). In conclusion, compared with RR, NRP appears to improve the short-term outcomes of cDCDD kidney transplants.
Identifiants
pubmed: 33891793
doi: 10.1111/ajt.16622
pii: S1600-6135(22)08794-9
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
3618-3628Informations de copyright
© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.
Références
Smith M, Dominguez-Gil B, Greer DM, et al. Organ donation after circulatory death: current status and future potential. Intensive Care Med. 2019;45(3):310-321. https://doi.org/10.1007/s00134-019-05533-0.
2018 Report of the Global Observatory Donation and Transplantation. http://www.transplant-observatory.org/. Accessed December 2020.
Domínguez-Gil B. Newsletter Transplant 2020; 25. https://www.edqm.eu/en/reports-and-publications. Accessed December 2020.
Thuong M, Ruiz A, Evrard P, et al. New classification of donation after circulatory death donors definitions and terminology. Transpl Int. 2016;29(7):749-759. https://doi.org/10.1111/tri.12776.
Lomero M, Gardiner D, Coll E, et al. Donation after circulatory death today: an updated overview of the European landscape. Transpl Int. 2020;33(1):76-88. https://doi.org/10.1111/tri.13506.
Summers DM, Watson CJ, Pettigrew GJ, et al. Kidney donation after circulatory death (DCD): state of the art. Kidney Int. 2015;88(2):241-249. https://doi.org/10.1038/ki.2015.88.
O'Neill S, Roebuck A, Khoo E, et al. A meta-analysis and meta-regression of outcomes including biliary complications in donation after cardiac death liver transplantation. Transpl Int. 2014;27(11):1159-1174. https://doi.org/10.1111/tri.12403.
Hessheimer AJ, Riquelme F, Fundora-Suárez Y, García Pérez R, Fondevila C. Normothermic perfusion and outcomes after liver transplantation. Transpl Rev. 2019;33(4):200-208.
Rubio JJ, Domínguez-Gil B, Miñambres E, et al. Role of normothermic perfusión with ECMO in donation after controlled cardiac death in Spain. Med Intensiva. 2020;S0210-5691(20):30066-30068. https://doi.org/10.1016/j.medin.2020.01.017.
Miñambres E, Rubio JJ, Coll E, Domínguez-Gil B. Donation after circulatory death and its expansion in Spain. Curr Opin Organ Transplant. 2018;23(1):120-129. https://doi.org/10.1097/MOT.0000000000000480.
Real Decreto 1723/2012, de 28 de diciembre, por el que se regulan las actividades de obtención, utilización clínica y coordinación territorial de los órganos humanos destinados al trasplante y se establecen requisitos de calidad y seguridad. https://www.boe.es/buscar/doc.php?id=BOE-A-2012-15715. Accessed May 2021.
Spanish National Consensus Document on Donation after the Circulatory Determination of Death. http://www.ont.es/infesp/DocumentosDeConsenso/DONACI%C3%93N%20EN%20ASISTOLIA%20EN%20ESPA%C3%91A.%20SITUACI%C3%93N%20ACTUAL%20Y%20RECOMENDACIONES.pdf. Accessed December 2020.
Annual Report on donation and transplantation activities in Spain. http://www.ont.es/infesp/Paginas/Memorias.aspx. Accessed December 2020.
Hessheimer AJ, Coll E, Torres F, et al. Normothermic regional perfusion vs. super-rapid recovery in controlled donation after circulatory death liver transplantation. J Hepatol. 2019;70(4):658-665. https://doi.org/10.1016/j.jhep.2018.12.013.
Watson CJE, Hunt F, Messer S, et al. In situ normothermic perfusion of livers in controlled circulatory death donation may prevent ischemic cholangiopathy and improve graft survival. Am J Transplant. 2019;19(6):1745-1758. https://doi.org/10.1111/ajt.15241.
Pérez-Villares JM, Rubio JJ, Del Río F, Miñambres E. Validation of a new proposal to avoid donor resuscitation in controlled donation after circulatory death with normothermic regional perfusion. Resuscitation. 2017;117:46-49. https://doi.org/10.1016/j.resuscitation.2017.05.030.
Austin PC. The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments. Stat Med. 2014;33(7):1242-1258.
Lemenkova P. K-means Clustering in R Libraries cluster and factoextra for Grouping Oceanographic Data. Int J Inform Appl Mathematics. 2019;2(1):1-26.
Coll E, Miñambres E, Sánchez-Fructuoso A, et al. Uncontrolled donation after circulatory death: a unique opportunity. Transplantation. 2020;104(8):1542-1552. https://doi.org/10.1097/TP.0000000000003139.
del Río F, Andrés A, Padilla M, et al. Kidney transplantation from donors after uncontrolled circulatory death: the Spanish experience. Kidney Int. 2019;95(2):420-428. https://doi.org/10.1016/j.kint.2018.09.014.
Reznik ON, Skvortsov AE, Reznik AO, et al. Uncontrolled donors with controlled reperfusion after sixty minutes of asystole: a novel reliable resource for kidney transplantation. PLoS One. 2013;8(5):e64209. https://doi.org/10.1371/journal.pone.0064209.
Molina M, Guerrero-Ramos F, Fernández-Ruiz M, et al. Kidney transplant from uncontrolled donation after circulatory death donors maintained by nECMO has long-term outcomes comparable to standard criteria donation after brain death. Am J Transplant. 2019;19(2):434-447. https://doi.org/10.1111/ajt.14991.
Antoine C, Savoye E, Gaudez F, et al. Kidney transplant from uncontrolled donation after circulatory death: contribution of normothermic regional perfusion. Transplantation. 2020;104(1):130-136. https://doi.org/10.1097/TP.0000000000002753.
Miñambres E, Rodrigo E, Suberviola B, et al. Strict selection criteria in uncontrolled donation after circulatory death provide excellent long-term kidney graft survival. Clin Transplant. 2020;23:e14010. https://doi.org/10.1111/ctr.14010.
Fondevila C, Hessheimer AJ, Flores E, et al. Applicability and results of Maastricht type 2 donation after cardiac death liver transplantation. Am J Transplant. 2012;12(1):162-170. https://doi.org/10.1111/j.1600-6143.2011.03834.x.
Jiménez-Romero C, Manrique A, Calvo J, et al. Liver Transplantation using uncontrolled donors after circulatory death: a 10-year single-center experience. Transplantation. 2019;103(12):2497-2505. https://doi.org/10.1097/TP.0000000000002780.
Savier E, Dondero F, Vibert E, et al. First experience of liver transplantation with type 2 donation after cardiac death in France. Liver Transpl. 2015;21(5):631-643. https://doi.org/10.1002/lt.24107.
Ravaioli M, De Pace V, Comai G, et al. Preliminary experience of sequential use of normothermic and hypothermic oxygenated perfusion for donation after circulatory death kidney with warm ischemia time over the conventional criteria - a retrospective and observational study. Transpl Int. 2018;31(11):1233-1244. https://doi.org/10.1111/tri.13311.
Mori G, Cerami C, Facchini F, et al. Kidney transplantation from circulatory death donors: monocentric Experience. Transplant Proc. 2019;51(9):2865-2867. https://doi.org/10.1016/j.transproceed.2019.07.012.
Foss S, Nordheim E, Sørensen DW, et al. First Scandinavian protocol for controlled donation after circulatory death using normothermic regional perfusion. Transplant Direct. 2018;4(7):e366. https://doi.org/10.1097/TXD.0000000000000802.
Rojas-Peña A, Sall LE, Gravel MT, et al. Donation after circulatory determination of death: the university of Michigan experience with extracorporeal support. Transplantation. 2014;98(3):328-334. https://doi.org/10.1097/TP.0000000000000070.
Oniscu GC, Randle LV, Muiesan P, et al. In situ normothermic regional perfusion for controlled donation after circulatory death-the United Kingdom experience. Am J Transplant. 2014;14(12):2846-2854. https://doi.org/10.1111/ajt.12927.
Miñambres E, Suberviola B, Dominguez-Gil B, et al. Improving the outcomes of organs obtained from controlled donation after circulatory death donors using abdominal normothermic regional perfusion. Am J Transplant. 2017;17(8):2165-2172. https://doi.org/10.1111/ajt.14214.
Gill J, Rose C, Lesage J, et al. Use and Outcomes of kidneys from donation after circulatory death donors in the United States. J Am Soc Nephrol. 2017;28(12):3647-3657. https://doi.org/10.1681/ASN.2017030238.
Heylen L, Jochmans I, Samuel U, et al. The duration of asystolic ischemia determines the risk of graft failure after circulatory-dead donor kidney transplantation: A Eurotransplant cohort study. Am J Transplant. 2018;18(4):881-889. https://doi.org/10.1111/ajt.14526.
Scalea JR, Redfield RR, Arpali E, et al. Does DCD donor time-to-death affect recipient outcomes? Implications of time-to-death at a high-volume center in the United States. Am J Transplant. 2017;17(1):191-200. https://doi.org/10.1111/ajt.13948.
Messer S, Cernic S, Page A, et al. A 5-year single-center early experience of heart transplantation from donation after circulatory-determined death donors. J Heart Lung Transplant. 2020;39(12):1463-1475. https://doi.org/10.1016/j.healun.2020.10.001.
Messer S, Page A, Colah S, et al. Human heart transplantation from donation after circulatory-determined death donors using normothermic regional perfusion and cold storage. J Heart Lung Transplant. 2018;37(7):865-869. https://doi.org/10.1016/j.healun.2018.03.017.
Tchana-Sato V, Ledoux D, Detry O, et al. Successful clinical transplantation of hearts donated after circulatory death using normothermic regional perfusion. J Heart Lung Transplant. 2019;38(6):593-598. https://doi.org/10.1016/j.healun.2019.02.015.
Tchana-Sato V, Ledoux D, Vandendriessche K, et al. First report of a successful pediatric heart transplantation from donation after circulatory death with distant procurement using normothermic regional perfusion and cold storage. J Heart Lung Transplant. 2019;38(10):1112-1115. https://doi.org/10.1016/j.healun.2019.08.009.
Pérez-Redondo M, Alcántara-Carmona S, Villar García S, et al. Transplantation of a heart donated after circulatory death via thoraco-abdominal normothermic regional perfusion and results from the first Spanish case. J Cardiothorac Surg. 2020;15(1):333. https://doi.org/10.1186/s13019-020-01372.
Miñambres E, Royo-Villanova M, Pérez-Redondo M, et al. Spanish experience with heart transplants from controlled donation after the circulatory determination of death using thoraco-abdominal normothermic regional perfusion and cold storage. Am J Transplant. 2020;21(4):1597-1602. https://doi.org/10.1111/ajt.16446.
Miñambres E, Ruiz P, Ballesteros MA, et al. Combined lung and liver procurement in controlled donation after circulatory death using normothermic abdominal perfusion. Initial experience in two Spanish centers. Am J Transplant. 2020;20(1):231-240. https://doi.org/10.1111/ajt.15520.
Tanaka S, Campo-Cañaveral de la Cruz JL, Crowley Carrasco S, et al. Effect on the donor lungs of using abdominal normothermic regional perfusion in controlled donation after circulatory death. Eur J Cardio-Thoracic Surg. 2021;59(2):359-366.
Shemie SD, Hornby L, Baker A, et al. International guideline development for the determination of death. Intensive Care Med. 2014;40(6):788-797. https://doi.org/10.1007/s00134-014-3242-7.
Gardiner D, McGee A, Bernat JL. Permanent brain arrest as the sole criterion of death in systemic circulatory arrest. Anaesthesia. 2020;75(9):1223-1228. https://doi.org/10.1111/anae.15050.
Hornby L, Dhanani S, Shemie SD. Update of a systematic review of autoresuscitation after cardiac arrest. Crit Care Med. 2018;46(3):e268-e272. https://doi.org/10.1097/CCM.0000000000002920.
Domínguez-Gil B, Ascher N, Capron AM, et al. Expanding controlled donation after the circulatory determination of death: statement from an international collaborative. Intensive Care Med. 2021;47(3):265-281. https://doi.org/10.1007/s00134-020-06341-7.
Manara A, Shemie SD, Large S, et al. Maintaining the permanence principle for death during in situ normothermic regional perfusion for donation after circulatory death organ recovery: a United Kingdom and Canadian proposal. Am J Transplant. 2020;20(8):2017-2025. https://doi.org/10.1111/ajt.15775.
Pérez Redondo M, Alcántara Carmona S, Fernández Simón I, et al. Implementation of a mobile team to provide normothermic regional perfusion in controlled donation after circulatory death: Pilot study and first results. Clin Transplant. 2020;34(8):e13899. https://doi.org/10.1111/ctr.13899.
van de Leemkolk FEM, Schurink IJ, Dekkers OM, et al. Abdominal normothermic regional perfusion in donation after circulatory death: a systematic review and critical appraisal. Transplantation. 2020;104(9):1776-1791. https://doi.org/10.1097/TP.0000000000003345.