冷缺血时间对肾移植的影响：配对供肾分析

Impact of Cold Ischemia Time on Kidney Transplant: A Mate Kidney Analysis.

作者信息

Gorayeb-Polacchini Fernanda Salomão, Caldas Heloisa Cristina, Fernandes-Charpiot Ida Maria Maximina, Ferreira-Baptista Maria Alice Sperto, Gauch Camila Ravazzi, Abbud-Filho Mario

机构信息

Laboratory of Immunology and Experimental Transplantation-LITEX, Medical School of Sao Jose do Rio Preto-FAMERP, Sao Jose do Rio Preto, SP, Brazil; Kidney Transplant Unit, Hospital de Base-FUNFARME, Sao Jose do Rio Preto, SP, Brazil.

Laboratory of Immunology and Experimental Transplantation-LITEX, Medical School of Sao Jose do Rio Preto-FAMERP, Sao Jose do Rio Preto, SP, Brazil.

出版信息

Transplant Proc. 2020 Jun;52(5):1269-1271. doi: 10.1016/j.transproceed.2019.12.052. Epub 2020 Mar 21.

DOI:10.1016/j.transproceed.2019.12.052

PMID:32204899

Abstract

INTRODUCTION

Longer cold ischemia time (CIT) is a deleterious factor for kidney transplant (KTx) outcomes and may lead Tx teams to graft discard. Because the CIT in Brazil is overall very high, the objective of this study was to compare outcomes among mate recipients of KTx with distinct CIT.

METHODS

We studied 106 mate recipients of KTx in a single center followed for 1-year post-Tx. Mate kidneys were analyzed comparing the first and the second recipient to be transplanted. In a second analysis, we grouped mate recipients according to the CIT: ≤ 20 hours, > 20 hours, and mixed CIT.

RESULTS

Seventy percent were standard criteria donors, with a mean Kidney Donor Profile Index (KDPI) of 61.5 ± 28%. KTx recipients presented an overall delayed graft function (DGF) rate of 82%, lasting 12 ± 7 days. The analysis of pairs considering the first and second recipient to be transplanted resulted in a longer CIT for the second (23.6 h vs 27 h; P = .001), and we did not find differences of outcomes after 1-year follow-up. Comparing pairs according to CIT (> 20h and ≤ 20h), DGF was higher in the CIT group > 20 hours (87.5% vs 58%; P = .002), with no differences of outcomes in 1-year follow-up. The logistic regression analysis shows that CIT > 20 hours is a risk factor for DGF in our study.

CONCLUSION

CIT > 20 hours is a risk factor for DGF, therefore strategies to reduce the CIT are always necessary.

摘要

引言

较长的冷缺血时间（CIT）是影响肾移植（KTx）结果的有害因素，可能导致移植团队放弃移植肾。由于巴西的CIT总体上非常高，本研究的目的是比较接受不同CIT的KTx配对受者的结局。

方法

我们在单一中心研究了106例KTx配对受者，术后随访1年。对配对肾进行分析，比较首次和第二次接受移植的受者。在第二项分析中，我们根据CIT将配对受者分组：≤20小时、>20小时和混合CIT。

结果

70%为标准标准供者，平均肾脏供者特征指数（KDPI）为61.5±28%。KTx受者的总体移植肾功能延迟（DGF）率为82%，持续12±7天。对考虑首次和第二次接受移植的受者的配对分析显示，第二次受者的CIT更长（23.6小时对27小时；P = 0.001），并且我们在1年随访后未发现结局差异。根据CIT（>20小时和≤20小时）比较配对，CIT>20小时组的DGF更高（87.5%对58%；P = 0.002），1年随访中结局无差异。逻辑回归分析表明，在我们的研究中，CIT>20小时是DGF的危险因素。