Victims of cardiac arrest occurring outside the hospital: a source of transplantable kidneys.
Ann Intern Med
; 145(3): 157-64, 2006 Aug 01.
Article
em En
| MEDLINE
| ID: mdl-16880457
ABSTRACT
BACKGROUND:
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).OBJECTIVE:
To compare graft survival rates among patients receiving kidneys from heart-beating donors versus type I or type II non-heart-beating donors.DESIGN:
Retrospective cohort study of transplantations performed from January 1989 to December 2004.SETTING:
Kidney transplant program of a teaching hospital in Madrid, Spain. PATIENTS 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]). MEASUREMENTS The primary outcome measure was graft survival. The median follow-up time was 68 months (range, 9 to 198 months).RESULTS:
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.LIMITATIONS:
This single-site, observational study was retrospective, and immunosuppressive therapy regimens given to transplant recipients varied over time.CONCLUSIONS:
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.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doadores de Tecidos
/
Transplante de Rim
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Sobrevivência de Enxerto
/
Parada Cardíaca
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Ann Intern Med
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Espanha