ORBi: Jochmans I. - The prognostic value of renal resistance during hypothermic machine perfusion of deceased donor kidneys

Reference : The prognostic value of renal resistance during hypothermic machine perfusion of decease...


	Document type :	Scientific journals : Short communication
	Discipline(s) :	Human health sciences : Surgery
	To cite this reference:	http://hdl.handle.net/2268/99860

Title :	The prognostic value of renal resistance during hypothermic machine perfusion of deceased donor kidneys
Language :	English
Author, co-author :	Jochmans, I. [ > > ]
	Moers, C. [ > > ]
	Smits, J. M. [ > > ]
	Leuvinink, H. G. D. [ > > ]
	Treckmann, J. [ > > ]
	Paul, A. [ > > ]
	Rahmel, A. [ > > ]
	SQUIFFLET, Jean-Paul [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie abdominale- endocrinienne et de transplantation >]
	van Heurn, E. [ > > ]
	Monbaliu, D. [ > > ]
	Ploeg, R. J. [ > > ]
	Pirenne, J. [ > > ]
Publication date :	2011
Journal title :	American Journal of Transplantation
Publisher :	Blackwell Publishing
Volume :	11
Pages :	2214-2220
ISSN :	1600-6135
e-ISSN :	1600-6143
Keywords :	[en] deceased donor kidneys ; delayed graft function ; hypothermic machine perfusion ; kidney transplantation ; renal resistance ; quality assessment ; viability testing
Abstract :	[en] Vascular renal resistance (RR) during hypothermic machine perfusion (HMP) is frequently used in kidney graft quality assessment. However, the association between RR and outcome has never been prospectively validated. Prospectively collected RR values of 302 machine-perfused deceased donor kidneys of all types (standard and extended criteria donor kidneys and kidneys donated after cardiac death), transplanted without prior knowledge of these RR values, were studied. In this cohort, we determined the association between RR and delayed graft function (DGF) and 1-year graft survival. The RR (mmHg/mL/min) at the end of HMP was an independent risk factor for DGF (odds ratio 21.12 [1.03–435.0]; p = 0.048) but the predictive value of RR was low, reflected by a c-statistic of the receiver operator characteristic curve of 0.58. The RR was also found to be an independent risk factor for 1-year graft failure (hazard ratio 12.33 [1.11–136.85]; p = 0.004). Determinants of transplant outcome are multifactorial in nature and this study identifies RR as an additional parameter to take into account when evaluating graft quality and estimating the likelihood of successful outcome. However, RR as a stand-alone quality assessment tool cannot be used to predict outcome with sufficient precision.
Target :	Researchers ; Professionals ; Students
Permalink :	http://hdl.handle.net/2268/99860

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