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Publication year
2012Source
Transplantation Proceedings, 44, 5, (2012), pp. 1222-6ISSN
Annotation
01 juni 2012
Publication type
Article / Letter to editor
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Organization
Nephrology
Urology
Surgery
Journal title
Transplantation Proceedings
Volume
vol. 44
Issue
iss. 5
Page start
p. 1222
Page end
p. 6
Subject
N4i 4: Auto-immunity, transplantation and immunotherapy; NCEBP 14: Cardiovascular diseases NCMLS 3: Tissue engineering and pathology; NCEBP 2: Evaluation of complex medical interventions; ONCOL 4: Quality of Care; IGMD 9: Renal disorderAbstract
BACKGROUND: Recent studies investigating early graft function (EGF) after living donor kidney transplantation (LDKT) identified prolonged warm ischemia time (WIT) as a risk factor for the occurrence of poor EGF. The latter is associated with long-term graft loss; therefore the question arises whether prolonged WIT affects long-term outcomes in LDKT. METHODS: Data were collected on 472 consecutive adult LDKTs. Patients were divided according to the total WIT into 3 groups with short (<30 minutes), intermediate (30-45 minutes), or prolonged (>45 minutes) WIT. RESULTS: Of all patients, 193 (40.9%) experienced short, 249 (52.8%) intermediate, and 30 (6.4%) prolonged WIT. Prolonged WIT was a significant risk factor for the occurrence of poor EGF with an adjusted odds ratio of 4.252 (95% confidence interval [CI), 1.914 -9.447). Long-term graft survival was impaired in patients with prolonged WIT, with an adjusted hazard ratio of 3.163 (95% CI, 1.202-8.321). Multivariate analysis revealed determinants of prolonged WIT, including laparoscopic procurement, recipient overweight, right donor kidney, and multiple renal arteries. CONCLUSION: Prolonged WIT impairs long-term graft survival in LDKT. This finding underlines the need to develop strategies to avoid the occurrence of prolonged WIT in LDKT.
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- Faculty of Medical Sciences [90373]
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