Journal article
Are we frozen in time? analysis of the utilization and efficacy of pulsatile perfusion in renal transplantation
American journal of transplantation, Vol.5(7), pp.1681-1688
2005
DOI: 10.1111/j.1600-6143.2005.00910.x
PMID: 15943626
Abstract
Preservation techniques are crucial to deceased donor kidney transplantation (DDTx), but the efficacy of pulsatile perfusion (PP) versus cold storage (CS) remains uncertain. We describe patterns of PP use and explore four fundamental questions. What kidneys are selected for PP? How does PP affect utilization of donated kidneys? What effect does PP have on outcomes? When does PP appear to be most efficacious? We examined rates of PP in DDTx in the United States from 1994 to 2003. We generated models for organ utilization, delayed graft function (DGF) and for the use of PP. We analyzed the long-term effect of PP with multivariate Cox models. The utilization rates for non-expanded criteria donors (ECDs) were similar by storage type, but for ECDs there was a significantly higher utilization rate with PP (70% with PP vs. 59% with CS, p < 0.001). Use of PP was widely variable across transplant centers. DGF rates were significantly lower with PP (27.6% vs. 19.6%). PP was associated with a mild benefit on death censored graft survival (adjusted hazard ratio = 0.88, 95% CI 0.85-0.91). Reduced DGF and significantly lower discard rates of ECDs associated with PP suggest an important utility of PP in renal transplantation. Additional evidence of improvement in graft survival, particularly in more recent years, provides further encouraging evidence for the use of PP.
Details
- Title: Subtitle
- Are we frozen in time? analysis of the utilization and efficacy of pulsatile perfusion in renal transplantation
- Creators
- Jesse D SCHOLD - Department of Medicine, University of Florida, Gainesville, FL, United StatesBruce KAPLAN - Department of Medicine, University of Florida, Gainesville, FL, United StatesRichard J HOWARD - Department of Surgery, University of Florida, Gainesville, FL, United StatesAlan I REED - Department of Surgery, University of Florida, Gainesville, FL, United StatesDavid P FOLEY - Department of Surgery, University of Florida, Gainesville, FL, United StatesHerwig-Ulf MEIER-KRIESCHE - Department of Medicine, University of Florida, Gainesville, FL, United States
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.5(7), pp.1681-1688
- DOI
- 10.1111/j.1600-6143.2005.00910.x
- PMID
- 15943626
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Publisher
- Blackwell; Oxford
- Language
- English
- Date published
- 2005
- Academic Unit
- Accounting; Surgery
- Record Identifier
- 9984051529702771
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