Salinas Sandy Jazmin Fragoso, Pérez Ramón Espinoza, López Martha Cruz, Moreno Madrigal Luis Guillermo, Hernández Rivera Juan Carlos H
Renal Transplant Unit, National Health Care Medical Center "Siglo XXI," IMSS, México City, Mexico.
Kidney Diseases Medical Research Unit, National Health Care Medical Center "Siglo XXI," IMSS, México City, México.
Transplant Proc. 2020 May;52(4):1118-1122. doi: 10.1016/j.transproceed.2020.02.010. Epub 2020 Mar 13.
Renal transplants (RTs) from deceased donors have increased in Mexico because of the high need of people with terminal kidney damage. The objective of this study is to determine the impact of cold ischemia time (CIT) on clinical outcomes in the deceased donor kidney transplant.
A retrospective, observational study of deceased donor RTs performed from 2013 to 2017 in the RT unit of the CMN Siglo XXI was completed. Data were collected from 202 patient records in this period; 7 clinical outcomes were determined, and logistic regression analysis was performed with CIT and extended criteria. The statistical package SPSS version 25 was used.
No risk was observed for clinical outcomes with a CIT of 1080 minutes, risk of delayed function and medical complications was observed with a CIT of 1260 minutes, and risk of surgical complications was observed with a CIT of 1309 minutes. There was a correlation of 0.556 between the Maryland classification score and post-transplant medical complications. The extended criteria are related to risk for death with an odds ratio of 6.91 (95% CI, 2.27-21.01; P = .001) CONCLUSIONS: CIT continues to be an extremely important factor in renal graft survival and post-transplant clinical conditions. The extended criteria represent a considerable risk of death.
由于终末期肾损伤患者的高需求,墨西哥已故供体的肾移植(RT)数量有所增加。本研究的目的是确定冷缺血时间(CIT)对已故供体肾移植临床结局的影响。
完成了一项对2013年至2017年在CMN Siglo XXI肾移植科进行的已故供体RT的回顾性观察研究。在此期间从202份患者记录中收集数据;确定了7种临床结局,并对CIT和扩展标准进行了逻辑回归分析。使用了统计软件包SPSS 25版。
CIT为1080分钟时未观察到临床结局风险,CIT为1260分钟时观察到功能延迟和医疗并发症风险,CIT为1309分钟时观察到手术并发症风险。马里兰分类评分与移植后医疗并发症之间的相关性为0.556。扩展标准与死亡风险相关,比值比为6.91(95%CI,2.27 - 21.01;P = .001)。结论:CIT仍然是肾移植存活和移植后临床状况的一个极其重要的因素。扩展标准代表了相当大的死亡风险。