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Increased Primary Non‐Function in Transplanted Deceased‐Donor Kidneys Flushed with Histidine‐Tryptophan‐Ketoglutarate Solution

Stevens, R. B. ; Skorupa, J. Y. ; Rigley, T. H. ; Yannam, G. R. ; Nielsen, K. J. ; Schriner, M. E. ; Skorupa, A. J. ; Murante, A. ; Holdaway, E. ; Wrenshall, L. E.

American journal of transplantation, 2009-05, Vol.9 (5), p.1055-1062 [Revista revisada por pares]

Malden, USA: Blackwell Publishing Inc

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Título:
Increased Primary Non‐Function in Transplanted Deceased‐Donor Kidneys Flushed with Histidine‐Tryptophan‐Ketoglutarate Solution
Autor: Stevens, R. B. ; Skorupa, J. Y. ; Rigley, T. H. ; Yannam, G. R. ; Nielsen, K. J. ; Schriner, M. E. ; Skorupa, A. J. ; Murante, A. ; Holdaway, E. ; Wrenshall, L. E.
Materias: Adenosine ; Adult ; Aged ; Allopurinol ; Biological and medical sciences ; Cadaver ; delayed graft function (DGF) ; Delayed Graft Function - epidemiology ; Female ; Glucose - adverse effects ; Glutathione ; HTK solution ; Humans ; Insulin ; Kidney Function Tests ; kidney transplantation ; Kidney Transplantation - physiology ; Male ; Mannitol - adverse effects ; Medical sciences ; Middle Aged ; organ preservation ; Organ Preservation Solutions - adverse effects ; Potassium Chloride - adverse effects ; primary nonfunction ; Procaine - adverse effects ; Raffinose ; Renal Dialysis ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Tissue Donors
Es parte de: American journal of transplantation, 2009-05, Vol.9 (5), p.1055-1062
Notas: This work was supported by the Ann Goldstein‐Cheryl Cooper New Frontiers in Transplant Medicine Fund.
Descripción: Histidine‐Tryptophan‐Ketoglutarate (HTK) solution is increasingly used to flush and preserve organ donor kidneys, with efficacy claimed equivalent to University of Wisconsin (UW) solution. We observed and reported increased graft pancreatitis in pancreata flushed with HTK solution, which prompted this review of transplanting HTK‐flushed kidneys. We analyzed outcomes of deceased‐donor kidneys flushed with HTK and UW solutions with a minimum of 12 months follow‐up, excluding pediatric and multi‐organ recipients. We evaluated patient and graft survival and rejection rates, variables that might constitute hazards to graft survival and renal function. Two‐year patient survival, rejection, renal function and graft survival were not different, but early graft loss (<6 months) was worse in HTK‐flushed kidneys (p < 0.03). A Cox analysis of donor grade, cold ischemic time, panel reactive antibodies (PRA), donor race, first vs. repeat transplant, rejection and flush solution showed that only HTK use predicted early graft loss (p < 0.04; relative risk = 3.24), almost exclusively attributable to primary non‐function (HTK, n = 5 (6.30%); UW, n = 1 (0.65%); p = 0.02). Delayed graft function and early graft loss with HTK occurred only in lesser grade kidneys, suggesting it should be used with caution in marginal donors. Deceased‐donor kidneys appear to be at an increased risk of primary non‐function after preservation with histidine‐tryptophan‐ketoglutarate solution. See article by Stewart et al on page 1048.
Editor: Malden, USA: Blackwell Publishing Inc
Idioma: Inglés

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Increased Primary Non‐Function in Transplanted Deceased‐Donor Kidneys Flushed with Histidine‐Tryptophan‐Ketoglutarate Solution

Stevens, R. B. ; Skorupa, J. Y. ; Rigley, T. H. ; Yannam, G. R. ; Nielsen, K. J. ; Schriner, M. E. ; Skorupa, A. J. ; Murante, A. ; Holdaway, E. ; Wrenshall, L. E.

Malden, USA: Blackwell Publishing Inc

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