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- Title
Victims of cardiac arrest occurring outside the hospital: a source of transplantable kidneys.
- Authors
Sánchez-Fructuoso AI; Marques M; Prats D; Conesa J; Calvo N; Pérez-Contín MJ; Blazquez J; Fernández C; Corral E; Del Río F; Núñez JR; Barrientos A; Sánchez-Fructuoso, Ana I; Marques, Maria; Prats, Dolores; Conesa, José; Calvo, Natividad; Pérez-Contín, M Jesús; Blazquez, Jesús; Fernández, Cristina
- Abstract
<bold>Background: </bold>The use of non-heart-beating donors could help shorten the list of patients who are waiting for a kidney transplant. Several reports describe acceptable results of transplantations from non-heart-beating donors who had in-hospital cardiac arrest, but few reports describe results of transplantations from non-heart-beating donors who had cardiac arrest that occurred outside of the hospital (Maastricht type I and type II donors).<bold>Objective: </bold>To compare graft survival rates among patients receiving kidneys from heart-beating donors versus type I or type II non-heart-beating donors.<bold>Design: </bold>Retrospective cohort study of transplantations performed from January 1989 to December 2004.<bold>Setting: </bold>Kidney transplant program of a teaching hospital in Madrid, Spain.<bold>Patients: </bold>320 patients who received a kidney transplant from non-heart-beating donors (273 type I donors and 47 type II donors) and 584 patients who received a kidney transplant from heart-beating donors divided into 2 groups according to donor age (age <60 years [n = 458] and age > or =60 years [n = 126]).<bold>Measurements: </bold>The primary outcome measure was graft survival. The median follow-up time was 68 months (range, 9 to 198 months).<bold>Results: </bold>One- and 5-year graft survival rates were 90.7% and 85.5%, respectively, for transplants from heart-beating donors younger than 60 years of age; 79.8% and 73.3%, respectively, for transplants from heart-beating donors 60 years of age or older (P < 0.001); and 87.4% and 82.1%, respectively, for transplants from non-heart-beating donors (P = 0.22 [vs. those from heart-beating donors < 60 years of age] and P = 0.014 [vs. those from heart-beating donors >or = 60 years of age]). Graft survival did not differ between patients who received kidneys from heart-beating donors younger than 60 years of age and patients who received kidneys from non-heart-beating donors.<bold>Limitations: </bold>This single-site, observational study was retrospective, and immunosuppressive therapy regimens given to transplant recipients varied over time.<bold>Conclusions: </bold>Outcomes of transplants from non-heart-beating donors and younger heart-beating donors are similar, and results for transplants from non-heart-beating donors improved compared with those from older heart-beating donors. On the basis of these results, the authors encourage other transplant units to adopt the use of type I and type II non-heart-beating donors.
- Publication
Annals of Internal Medicine, 2006, Vol 145, Issue 3, p157
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-145-3-200608010-00003