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SHR Neuro Cancer Cardio Lipid Metab Microb

Denecke, C; Biebl, M; Fritz, J; Brandl, A; Weiss, S; Dziodzio, T; Aigner, F; Sucher, R; Bösmüller, C; Pratschke, J; Öllinger, R.
Reduction of Cold Ischemia Time and Anastomosis Time Correlates with Lower Delayed Graft Function Rates Following Transplantation of Marginal Kidneys.
Ann Transplant. 2016; 21:246-55 Doi: 10.12659/aot.896672
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Sucher Robert
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Abstract:: BACKGROUND In kidney transplantation, the association of cold ischemia time (CIT), anastomosis time (AT), and delayed graft function (DGF) is particularly detrimental in grafts from marginal donors; however, actual cut-off criteria are still debated. MATERIAL AND METHODS Data from patients >65 years (n=193) and patients <65 years (n=1054) transplanted between 2000 and 2010 were retrospectively analyzed regarding the age-dependent impact of ischemia times and DGF. RESULTS Overall death censored graft survival was inferior for ECD/DCD organs. Graft survival was significantly impaired by DGF in younger and older recipients. The multivariate analysis revealed an age-dependent profile of risk factors for DGF. In younger patients, multiple risk factors were identified while in patients >65 years, only CIT and AT were correlated with DGF. Marginal grafts with a CIT<769 min had a comparable outcome to any SCD organ; extended CIT >770 min worsened ECD/DCD survival significantly. Similarly, AT longer than 26 min was associated with a significantly impaired survival of ECD/DCD grafts. In a Cox regression analysis with penalized splines, this increased risk of graft loss was not linear: CIT beyond 800 min and AT beyond 20 min were cut-off values associated with worse outcomes in marginal organs. CONCLUSIONS Thus, risk factors for DGF are age-dependent; keeping ischemia times below these thresholds offers outcome of ECD/DCD organs comparable to SCD organs.
Find related publications in this database (using NLM MeSH Indexing): Adult - administration & dosage; Age Factors - administration & dosage; Aged - administration & dosage; Cold Ischemia - adverse effects; Delayed Graft Function - etiology; Female - administration & dosage; Graft Survival - physiology; Humans - administration & dosage; Kidney Transplantation - adverse effects; Male - administration & dosage; Middle Aged - administration & dosage; Retrospective Studies - administration & dosage; Risk Factors - administration & dosage; Time Factors - administration & dosage; Treatment Outcome - administration & dosage
Find related publications in this database (Keywords): Cold Ischemia; Frail Elderly; Kidney Transplantation; Warm Ischemia