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See detailMachine Perfusion or cold storage in deceased-donor kidney transplantation
Moers, C.; Smits, J.; Maathuis, M. H. et al

in New England Journal of Medicine [=NEJM] (2009), 360

BACKGROUND Static cold storage is generally used to preserve kidney allografts from deceased donors. Hypothermic machine perfusion may improve outcomes after transplantation, but few sufficiently powered ... [more ▼]

BACKGROUND Static cold storage is generally used to preserve kidney allografts from deceased donors. Hypothermic machine perfusion may improve outcomes after transplantation, but few sufficiently powered prospective studies have addressed this possibility. METHODS In this international randomized, controlled trial, we randomly assigned one kidney from 336 consecutive deceased donors to machine perfusion and the other to cold storage. All 672 recipients were followed for 1 year. The primary end point was delayed graft function (requiring dialysis in the first week after transplantation). Secondary end points were the duration of delayed graft function, delayed graft function defined by the rate of the decrease in the serum creatinine level, primary nonfunction, the serum creatinine level and clearance, acute rejection, toxicity of the calcineurin inhibitor, the length of hospital stay, and allograft and patient survival. RESULTS Machine perfusion significantly reduced the risk of delayed graft function. Delayed graft function developed in 70 patients in the machine-perfusion group versus 89 in the cold-storage group (adjusted odds ratio, 0.57; P = 0.01). Machine perfusion also significantly improved the rate of the decrease in the serum creatinine level and reduced the duration of delayed graft function. Machine perfusion was associated with lower serum creatinine levels during the first 2 weeks after transplantation and a reduced risk of graft failure (hazard ratio, 0.52; P = 0.03). One-year allograft survival was superior in the machine-perfusion group (94% vs. 90%, P = 0.04). No significant differences were observed for the other secondary end points. No serious adverse events were directly attributable to machine perfusion. CONCLUSIONS Hypothermic machine perfusion was associated with a reduced risk of delayed graft function and improved graft survival in the first year after transplantation. (Current Controlled Trials number, ISRCTN83876362.) [less ▲]

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See detailAn 11 - Year Overview of the belgian donor and transplant statistics bsed on a consecutive yearly data follow-up and comparing two periods : 1997 to 2005 versus 2006 to 2007
Van Gelder, F.; Delbouille, Marie-Hélène ULg; Vandervennet, M. et al

in Transplantation Proceedings (2009), 41

Background. The Belgian Transplant Coordinators Section is responsible for the yearly data follow-up concerning donor and transplantation statistics in Belgium and presents herein a 10-year overview ... [more ▼]

Background. The Belgian Transplant Coordinators Section is responsible for the yearly data follow-up concerning donor and transplantation statistics in Belgium and presents herein a 10-year overview. Methods. The procurement and transplant statistics were compared between 2 periods: Period 1 (P1, 1997–2005) versus Period 2 (P2, 2006–2007). Results. The kidney and liver waiting lists (P1 vs P2) showed an overall decrease for a period of 2 consecutive years in P2; kidney ( 170 patients; 18%), and liver ( 83 patients; 34%). All other waiting lists (heart, lung, pancreas) remained stable. Mean ED further increased (P1 vs P2); 229 (P1) versus 280 (P2, 22.27%). Non–heart-beating donors were significantly ( 288%) more often procured in P2. Mean donor age was 37.9 17.8 years (P1) versus 46.5 19.9 years (P2), and mean organ yield per donor was 3.48 1.7 (P1) versus 3.38 1.8 (P2). Overall transplant activity per million inhabitants increased 21.1%. Conclusion. For 2 consecutive years, the Belgian statistics showed significantly increased donor activity with an impact on waiting list dynamics and transplantation. The mean organ yield per donor was not influenced despite an increased average age and change in reason for death. [less ▲]

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See detailOverview of the Belgian Donor and Transplant Statistics 2006: Results of Consecutive Yearly Data Follow-up by the Belgian Section of Transplant Coordinators
Van Gelder, F.; Delbouille, Marie-Hélène ULg; Vandervennet, M. et al

in Transplantation Proceedings (2007), 39

Background. The Belgian Section of Transplant Coordinators, created in 1997 under the auspices of the Belgian Transplant Society, is in charge of the collection of the national data about donor ... [more ▼]

Background. The Belgian Section of Transplant Coordinators, created in 1997 under the auspices of the Belgian Transplant Society, is in charge of the collection of the national data about donor/procurement activities. Methods. Data are collected in all Belgian transplant centers. An annual report is finalized by combining these data with data from the Eurotransplant database. Results. An increase of both potential donors (n 501, 14.4%) and effective donors (n 273, 16.7%) was observed in 2006 versus 2005. Among effective donors, 28 were non–heart-beating donors (10.25%). Overall donor ratio was 26.26 donors per million inhabitants. Within potential donors, absence of organ harvesting was due to medical contraindications (28%), family refusal (13%), or legal refusal (2%). Donor mean age was 46.4 years and mean organs/donor was 3.21 1.7. An overall reduction of Belgian waiting lists was observed in 2006 as compared with 2005 ( 5.7% for kidney, 25.7% for liver, 9.4% for heart, 6.7% for lung, and 11.7% for pancreas), while waiting list mortality was 18% for liver, 11% for heart, and 7% for lung. As compared with 2005, transplant activities increased for kidney (n 485, 24.3%), heart lungs (n 73, 7.3%), and lungs (n 83, 39.4%) but decreased for liver (n 236, 2.1%). Living donation represented 8.45% for kidney ( 28.1% vs 2005) and 8% for liver transplantation ( 29.6%). Conclusion. Globally, a marked increase of procurement and transplant activities was observed in 2006, allowing to limit waiting list and waiting list mortality. Further increase of living donor activity and non–heart-beating donation remains necessary to extend the donor pool. [less ▲]

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