ABSTRACT
Operations of transplantation of kidneys taken from donors with expanded criteria with satisfactory results were made on 27 recipients of the older age group (from 60 through 76 years). Standard transplantation of the kidney was made to 20 recipients, and dual renal transplantation to 7 recipients. Mean level of creatinine in elderly patients on the 21st day was (340.9 +/- 49.3) microM/l, on the 90th day (124.6 +/- 6.9) microMl/l.
Subject(s)
Donor Selection , Kidney Transplantation , Kidney , Organ Preservation , Tissue and Organ Harvesting , Aged , Cadaver , Cause of Death , Donor Selection/methods , Donor Selection/standards , Female , Humans , Kidney Failure, Chronic/physiopathology , Kidney Failure, Chronic/surgery , Kidney Function Tests , Kidney Transplantation/methods , Kidney Transplantation/standards , Male , Middle Aged , Organ Preservation/methods , Organ Preservation/standards , Patient Selection , Tissue and Organ Harvesting/methods , Tissue and Organ Harvesting/standards , Treatment OutcomeABSTRACT
The authors consider actuality of using apparatus perfusion of renal transplants for the distension of the door pool and improvement of quality of transplantation. The article contains the results of the first in Russia clinical application of apparatus perfusion in the work with asystolic donors. The data are presented on possibility of using the apparatus perfusion of renal transplants for their testing, selection and improving results of transplantation.
Subject(s)
Kidney Transplantation/methods , Perfusion/instrumentation , Preoperative Care/methods , Adult , Equipment Design , Female , Humans , Kidney Failure, Chronic/surgery , Male , Middle Aged , Reperfusion Injury/prevention & control , Reproducibility of Results , Retrospective StudiesABSTRACT
The use of kidneys from uncontrolled donors after cardiac death (uDCD) remains disputable due to significant warm ischemia time (WIT) causing ischemia-reperfusion injuries. The aim of study was to use machine perfusion as a tool for preoperative selection and recovery of kidneys obtained from 22 uDCDs from December 2005 until July 2007. The results of transplantation of 21 pump-perfused kidneys (study group) were compared with 17 cold-stored kidneys (control group) from the same donors. The use of pulsatile perfusion allowed kidney transplantation from nine marginal uDCDs with extreme WIT (59 to 65 minutes). At the same time, we discarded five paired kidneys from the control group. The rate of immediate function among the study group was 30% greater than that in the control group. The creatinine level in control group was twice as high on day 21 and at 3 months after transplantation than among the study group. A considerable number of complications and the negative effects correlated with the cold-stored group of kidneys. In conclusion, machine perfusion is an instrument to select kidneys from uDCDs at the preoperative stage, thereby improving postoperative function of these grafts.
