Department of Renal Transplantation, Queen Elizabeth University Hospital, Glasgow, UK.
Institute of Cardiovascular and Molecular Sciences, University of Glasgow, Glasgow, UK.
Clin Transplant. 2021 Oct;35(10):e14431. doi: 10.1111/ctr.14431. Epub 2021 Aug 3.
In order to expand the pool of usable donors from circulatory death (DCD) there is increasing interest in normothermic regional perfusion (NRP) to assess and improve liver viability. NRP may also improve outcomes in kidney transplantation.We present our single center experience of outcomes in imported kidneys following NRP.
Data was obtained from a prospectively maintained database between December 2012 and September 2018. Primary endpoints were incidence of delayed graft function (DGF) and estimated glomerular filtration rate (eGFR).
Six-hundred and thirty-two decease donor kidneys were transplanted, 229 from DCD donors, 29 of which had NRP. The DGF rate was lower for NRP versus DCD (six of 29, 20.7% vs. 70 of 200, 35.0%) with reduced duration of DGF. Multivariate analysis demonstrated transplant type to be a statistically significant independent predictor of eGFR at 7 and 14 days. Early transplant function in NRP kidneys was comparable to DBD. There were no graft losses within 30 days in the NRP group. One-year graft loss rate was 3.4% for NRP and 6.0% for standard DCD.
This data suggests NRP is safe, and reduces rates of DGF and improves early renal transplant function.
为了扩大可利用的循环死亡（DCD）供体池，人们对常温区域灌注（NRP）越来越感兴趣，以评估和改善肝脏活力。NRP 也可能改善肾移植的效果。我们报告了我们中心对经过 NRP 的进口肾脏的结果的单中心经验。
数据来自 2012 年 12 月至 2018 年 9 月期间一个前瞻性维护的数据库。主要终点是迟发性移植物功能障碍（DGF）和估算肾小球滤过率（eGFR）的发生率。
共移植了 632 例死亡供体肾脏，其中 229 例来自 DCD 供体，其中 29 例进行了 NRP。NRP 的 DGF 发生率低于 DCD（29 例中有 6 例，20.7%，200 例中有 70 例，35.0%），DGF 持续时间缩短。多变量分析表明，移植类型是 7 天和 14 天 eGFR 的统计学上显著的独立预测因素。NRP 肾脏的早期移植功能与 DBD 相当。NRP 组在 30 天内没有移植物丢失。NRP 组的 1 年移植物丢失率为 3.4%，标准 DCD 组为 6.0%。
该数据表明 NRP 是安全的，可降低 DGF 的发生率，并改善早期肾移植功能。
