Article ; Online: Impact of spontaneous donor hypothermia on graft outcomes after kidney transplantation.
2017 Volume 18, Issue 3, Page(s) 704–714
Abstract: A previous donor intervention trial found that therapeutic hypothermia reduced delayed graft function (DGF) after kidney transplantation. This retrospective cohort study nested in the randomized dopamine trial (ClinicalTrials.gov identifier: NCT000115115) ...
| Abstract | A previous donor intervention trial found that therapeutic hypothermia reduced delayed graft function (DGF) after kidney transplantation. This retrospective cohort study nested in the randomized dopamine trial (ClinicalTrials.gov identifier: NCT000115115) investigates the effects of spontaneous donor hypothermia (core body temperature <36°C) on initial kidney graft function, and evaluates 5-year graft survival. Hypothermia assessed by a singular measurement in the intensive care unit 4-20 hours before procurement was associated with less DGF after kidney transplantation (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.34-0.91). The benefit was greater when need for more than a single posttransplant dialysis session was analyzed (OR 0.48, 95%CI 0.28-0.82). Donor dopamine ameliorated dialysis requirement independently from hypothermia in a temporal relationship with exposure (OR 0.93, 95%CI 0.87-0.98, per hour). A lower core body temperature in the donor was associated with lower serum creatinine levels before procurement, which may reflect lower systemic inflammation and attenuated renal injury from brain death. Despite a considerable effect on DGF, our study failed to demonstrate a graft survival advantage (hazard ratio [HR] 0.83, 95%CI 0.54-1.27), whereas dopamine treatment was associated with improved long-term outcome (HR 0.95, 95%CI 0.91-0.99 per hour). |
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| MeSH term(s) | Brain Death ; Case-Control Studies ; Delayed Graft Function/epidemiology ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Graft Survival ; Humans ; Hypothermia ; Incidence ; Kidney Failure, Chronic/mortality ; Kidney Failure, Chronic/surgery ; Kidney Function Tests ; Kidney Transplantation/mortality ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tissue Donors/supply & distribution |
| Language | English |
| Publishing date | 2017-11-22 |
| Publishing country | United States |
| Document type | Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 2060594-8 |
| ISSN | 1600-6143 ; 1600-6135 |
| ISSN (online) | 1600-6143 |
| ISSN | 1600-6135 |
| DOI | 10.1111/ajt.14541 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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