@article{10902/32570,
year = {2022},
url = {https://hdl.handle.net/10902/32570},
abstract = {Objectives: The number of kidney transplants obtained from controlled donations after circulatory death is increasing, with long-term outcomes similar to those obtained with donations after brain death. Extraction using normothermic regional perfusion can improve results with controlled donors after circulatory death; however, information on the histological impact and extraction procedure is scarce.
Materials and methods: We retrospectively investigated all kidney transplants performed from October 2014 to December 2019, in which a follow-up kidney biopsy had been performed at 1-year follow-up, comparing controlled procedures with donors after circulatory death and normothermic regional perfusion versus donors after brain death. Interstitial fibrosis/tubular atrophy was assessed by adding the values of interstitial fibrosis and tubular atrophy, according to the Banff classification of renal allograft pathology.
Results: When we compared histological data from 66 transplants with donations after brain death versus 24 transplants with donations after circulatory death and normothermic regional perfusion, no differences were found in the degree of fibrosis in the 1-year follow-up biopsy (1.7 ± 1.3 vs 1.7 ± 1.1; P = .971) or in the ratio of patients with increased fibrosis calculated as interstitial fibrosis/tubular atrophy >2 (18% vs 13%; P = .522). In our multivariate analysis, which included acute rejection, expanded criteria donation, and the type of donation, no variable was independently related to an increased risk of interstitial fibrosis/tubular atrophy >2.
Conclusions: The outcomes of kidney grafts procured in our center using controlled procedures with donors after circulatory death and normothermic regional perfusion were indistinguishable from those obtained from donors after brain death, showing the same degree of fibrosis in the 1-year posttransplant surveillance biopsy. Our data support the conclusion that normothermic regional perfusion should be the method of choice for extraction in donors after circulatory death.},
organization = {This work was sponsored by the Ministry of Science and Innovation, the Carlos III Health Institute and the European Regional Development Fund Research Network for Kidney Diseases (“RedInRen” RD16/0009/0027), and Networks for Cooperative Research Health Results (“RICORS2040” RD21/0005/0010). The authors have no declarations of potential conflicts of interest.},
publisher = {Baskent University},
publisher = {Experimental and Clinical Transplantation, 2022, 12, 1069-1075},
title = {Controlled donation after circulatory death using normothermic regional perfusion does not increase graft fibrosis in the first year posttransplant surveillance biopsy},
author = {Barreda, Paloma and Miñambres García, Eduardo and Ballesteros Sanz, María Ángeles and Mazón, Jaime and Gómez Román, José Javier and Gómez Ortega, José María and Belmar Vega, Lara and Valero San Cecilio, Rosalía María and Ruiz San Millán, Juan Carlos and Rodrigo Calabia, Emilio},
}