Title
Kidney donation after circulatory death in a country with a high number of brain dead donors : 10-year experience in Belgium Kidney donation after circulatory death in a country with a high number of brain dead donors : 10-year experience in Belgium
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Heidelberg ,
Subject
Human medicine
Source (journal)
Transplant international. - Heidelberg, 1988
Volume/pages
25(2012) :8 , p. 857-866
ISSN
0934-0874
1432-2277
0934-0874
ISI
000306273400010
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Worldwide shortage of standard brain dead donors (DBD) has revived the use of kidneys donated after circulatory death (DCD). We reviewed the Belgian DCD kidney transplant (KT) experience since its reintroduction in 2000. Risk factors for delayed graft function (DGF) were identified using multivariate analysis. Five-year patient/graft survival was assessed using KaplanMeier curves. The evolution of the kidney donor type and the impact of DCDs on the total KT activity in Belgium were compared with the Netherlands. Between 2000 and 2009, 287 DCD KT were performed. Primary nonfunction occurred in 1% and DGF in 31%. Five-year patient and death-censored graft survival were 93% and 95%, respectively. In multivariate analysis, cold storage (versus machine perfusion), cold ischemic time, and histidine-tryptophan-ketoglutarate solution were independent risk factors for the development of DGF. Despite an increased number of DCD donations and transplantations, the total number of deceased KT did not increase significantly. This could suggest a shift from DBDs to DCDs. To increase KT activity, Belgium should further expand controlled DCD programs while simultaneously improve the identification of all potential DBDs and avoid their referral for donation as DCDs before brain death occurs. Furthermore, living donation remains underused.
E-info
https://repository.uantwerpen.be/docman/iruaauth/14a701/5232490.pdf
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Handle