scholarly journals The impact of cold ischemia time on renal transplant outcome

2015 ◽  
Vol 87 (2) ◽  
pp. 272-275 ◽  
Author(s):  
Claudio E. Ponticelli
2016 ◽  
Vol 19 (3) ◽  
pp. 6-9
Author(s):  
André Barros Albuquerque Esteves ◽  
Luiz Roberto Sousa Ulisses ◽  
Leonardo Figueiredo Camargo ◽  
Gabriel Giollo Rivelli ◽  
Marcos Vinicius de Sousa ◽  
...  

Polyomavirus allograft nephropathy (PVAN) has a negative impact on allograft function and survival. Analysis of paired kidneys from same donor can help to understand the role of recipient risk factors for PVAN. This analysis can also define donor related risk factors. Purpose: To identify recipient related risk factors for PVAN. Patients and Methods: Transversal cohort of 24 renal transplant patients in regular outpatient clinic follow up. Twelve patients with PVAN and their paired controls (recipients from same donor) without decoy cells in cytology were included in this analysis. Medical records were analyzed for demographic data, information of transplant and post-transplant data (acute rejection, renal function, immunosuppression). Results: Groups were comparable for initial immunosuppressive therapy based on basiliximab induction, tacrolimus, mycophenolate and steroids. Etiology of end-stage renal disease, race, age, HLA matching and delayed graft function considered as risk factors were also similar between patients with or without PVAN. However, PVAN group had more male patients (91.6 vs. 66.6%, PVAN versus control, p<0.05), higher incidence of biopsy proven acute rejection (41.6% vs. 8.3%, PVAN vs. control, p<0.05) and a trend to shorter cold ischemia time (15.6+6.2 versus 19.7+5.0, p=0.06). Conclusion: In this series, there were no significant differences in immunosuppressive therapy, age and HLA matching between patients with or without PVAN common risk factors. The only factors to be considered in this series were older age and a trend to shorter cold ischemia time in PVAN patients.


2020 ◽  
Author(s):  
Wenlong Huang ◽  
Hirofumi Shimizu ◽  
John Bianchi ◽  
Kaja Matovinovic ◽  
David L. Ayares ◽  
...  

2000 ◽  
Vol 32 (8) ◽  
pp. 2586-2588 ◽  
Author(s):  
T Michelon ◽  
F Piovesan ◽  
P Santos ◽  
A Santos ◽  
E Keitel ◽  
...  

1996 ◽  
Vol 16 (12) ◽  
pp. 1516-1523 ◽  
Author(s):  
Johannes Waltenberger ◽  
M. Levent Akyürek ◽  
Magnus Aurivillius ◽  
Alkwin Wanders ◽  
Erik Larsson ◽  
...  

Peptide growth factors have been reported to contribute to the atherogenic process, and they are known to mediate signals for vascular remodeling. Using syngeneic and allogeneic rat aorta transplant models, we analyzed the impact of cold ischemia time up to 24 hours and reperfusion injury on development of transplant arteriosclerosis during the first 2 months after transplantation. The expression of the transforming growth factor-β (TGF-β) family as well as the platelet-derived growth factor (PDGF) and its receptors was studied by use of immunohistochemistry, followed by semiquantitative evaluation and multivariate analysis. In the syngeneically transplanted aortas, the expression of TGF-β1, PDGF, and the two PDGF receptors in the neointima increased significantly with the extent of cold ischemia time. Furthermore, there was a significant induction of the latent TGF-β binding protein in the neointima as well as TGF-β2 in the media, both correlating with the observation time after transplantation. In the allogeneic grafts, all examined proteins were already induced strongly 2 weeks after transplantation, even at the shortest ischemic period studied (1 hour). However, no positive correlation between growth factor expression and cold ischemia or observation time could be found. Double immunohistochemistry revealed that macrophages express PDGF and its receptors as well as TGF-β1. Smooth muscle cells express both types of PDGF receptors, and a few T cells express TGF-β1 as well as PDGF receptors. In summary, TGF-β and PDGF are induced by allogeneic as well as ischemic stimuli in transplanted aortas, suggesting a role in the pathogenesis of transplant arteriosclerosis and representing a potential target for therapeutic intervention.


Author(s):  
Alexandre Coutinho Teixeira de FREITAS ◽  
Desirée de Marillac Nascimento de MATOS ◽  
Jorge Amilton Tosato MILSTED ◽  
Julio Cezar Uili COELHO

ABSTRACT Background : Cold ischemia time is related to success of liver transplantation. Aim : To compare the impact of cold ischemia time on allografts locally collected to those collected distantly. Methods : Were evaluated 83 transplantations. The patients were divided in two groups: those who received liver grafts collected from cities out of Curitiba (n=42) and locally (n=41). From the donors were compared: cause of death, days at ICU, cardiac arrest, vasoactive drugs, lab exams, gender, age, and BMI. Were compared the subsequent information of receptors: cold ischemia time, warm ischemia time, length of surgery, lab exams, etiology of cirrhosis, MELD score, age, gender, histology of graft, use of vasoactive drugs, and blood components transfusion. Were evaluated the correlation between cold ischemia time and lab results. Results : The liver grafts collected from other cities were submitted to a longer cold ischemia time (500±145 min) compared to those locally collected (317,85±105 min). Donors from other cities showed a higher serum sodium level at donation (154±16 mEq/dl) compared to those from Curitiba (144±10 mEq/dl). The length of cold ischemia time was related to serum levels of ALT and total bilirubin. Conclusion : Liver grafts distantly collected underwent longer cold ischemia times, although it caused neither histologic injuries nor higher transfusion demands. There is a correlation between cold ischemia time and hepatic injury, translated by elevation of serum ALT and total bilirubin levels.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Carolina Figueiredo ◽  
Mariana Fernandes ◽  
Filipe Mira ◽  
Clara Pardinhas ◽  
Rita Leal ◽  
...  

Abstract Background and Aims Delayed graft function (DGF), defined as the need for dialysis within one week post-transplantation, is associated with poorer kidney graft survival. We aimed to identify risk factors for DGF throughout 3 decades and evaluate their effect on graft survival. Method Retrospective study including 3081 kidney transplants performed at our transplantation unit between January 1st, 1989 and December 31st, 2018, split in 3 decades (1: 1989-1998; 2: 1999-2008; 3: 2009-2018). Data regarding donor and recipient demographics, time on dialysis, immunization, cold ischemia time, hemodynamic parameters and immunosuppression were collected from our prospectively maintained data base. Results Main donor, recipient and perioperative characteristics are summarized in table 1. There were clear differences in these characteristics between the decades, standing out more adverse features from both recipients and donors. Overall incidence rate of DGF was 16% (n=493): 14% in decade 1; 19.3% in decade 2 and 15% in decade 3. On univariate analysis, most studied variables included in table 1 were statistically significant as predictors of DGF. However, on multivariate analysis, we found that in the first decade the predominant risk factors for DGF were pre-transplant dialysis time and cold-ischemia time, whilst in the following decades donor characteristics, as well as recipient’s weight became more relevant (table 2). Conclusion The observed shift from donor-unrelated variables in the first decade into donor-related variables in the second and third decades as the main determinants of DGF highlights the impact of expanding donor’s acceptance criteria. Nevertheless, the increase in expanded criteria donors did not translate into poorer overall results, probable contributors being shorter cold-ischemia times and stronger immunosuppression.


2008 ◽  
Vol 86 (Supplement) ◽  
pp. 580
Author(s):  
A Adamowicz ◽  
P Stróecki ◽  
M Kozowski ◽  
Z Wodarczyk ◽  
J Manitius

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