Pérez-Canga J L, Martín Penagos L, Ballestero Diego R, Valero San Cecilio R, Rodrigo Calabia E, Belmar Vega L, Serrano Soto M, Ruiz Martínez L, Lopez Del Moral Cuesta C, Ruiz San Millán J C
Department of Nephrology, Marques of Valdecilla University Hospital, Santander, Spain.
Department of Nephrology, Marques of Valdecilla University Hospital, Santander, Spain.
Transplant Proc. 2019 Mar;51(2):321-323. doi: 10.1016/j.transproceed.2018.10.012. Epub 2018 Oct 30.
Kidney transplantation procedures commonly result in a cold ischemia time (CIT) gap when both kidney grafts are implanted in the same center. Owing to logistics, the procedure is usually consecutive, first accomplishing one surgery and then the other. CIT constitutes an independent risk factor for the development of delayed graft function (DGF) in kidney transplants. The effect that CIT exerts on graft and patient survival is still unclear. This study evaluates the relation of CIT and transplant outcomes by comparing paired kidney transplants in terms of survival and graft function.
We accomplished a retrospective analysis of 402 kidney transplants performed in our center between 2000 and 2017. We selected all transplants where both organs from the same donor were implanted at our hospital, establishing 2 study groups (group 1: first graft implanted and group 2: second graft implanted) to compare by paired data statistical methods.
We found an increase in the incidence of DGF in group 2 (42% vs 28.8%; P < .05). Group 2 had significantly worse graft function on day 5 posttransplant (4.7 ± 2.88 vs 3.86 ± 2.8 mg/dL of serum creatinine; P < .05). No significant differences in graft function were found on days 30 and 90 posttransplant. We didn't find any difference in graft survival between both groups. Length of hospitalization stay (17.6 days [± 13] vs 21.6 days [± 17]) and hemodialysis sessions (mean of 2.8 [± 2] vs 3.6 [± 2.2]) were higher in group 2.
CIT acts as an independent risk factor for the development of DGF in kidney transplantation. CIT had no isolated effect on graft survival.
当两个肾移植器官在同一中心植入时，肾移植手术通常会导致冷缺血时间（CIT）间隔。由于后勤原因，手术通常是连续进行的，先完成一台手术，然后再进行另一台。CIT是肾移植中发生移植肾功能延迟恢复（DGF）的一个独立危险因素。CIT对移植肾和患者存活的影响仍不清楚。本研究通过比较配对肾移植的存活情况和移植肾功能，评估CIT与移植结局的关系。
我们对2000年至2017年在本中心进行的402例肾移植进行了回顾性分析。我们选择了所有在我院植入同一供体的两个器官的移植病例，设立2个研究组（第1组：植入第一个移植肾；第2组：植入第二个移植肾），采用配对数据统计方法进行比较。
我们发现第2组DGF的发生率有所增加（42%对28.8%；P<0.05）。第2组在移植后第5天的移植肾功能明显较差（血清肌酐为4.7±2.88对3.86±2.8mg/dL；P<0.05）。移植后第30天和第90天的移植肾功能无显著差异。两组间移植肾存活情况未发现差异。第2组的住院时间（17.6天[±13]对21.6天[±17]）和血液透析次数（平均2.8[±2]对3.6[±2.2]）更高。
CIT是肾移植中发生DGF的独立危险因素。CIT对移植肾存活无单独影响。
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