scholarly journals EFFECTS OF COLD ISCHEMIA TIME ON HEPATIC ALLOGRAFT FUNCTION

2017 ◽  
Vol 30 (4) ◽  
pp. 239-243 ◽  
Author(s):  
Alexandre Coutinho Teixeira de FREITAS ◽  
Desirée de Marillac Nascimento de MATOS ◽  
Jorge Amilton Tosato MILSTED ◽  
Julio Cezar Uili COELHO
Keyword(s):  
Total Bilirubin ◽  
Serum Levels ◽  
Meld Score ◽  
Cold Ischemia Time ◽  
Vasoactive Drugs ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
Allograft Function ◽  
The Impact ◽  
Hepatic Allograft

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.

scholarly journals Ischemia-Induced Transplant Arteriosclerosis in the Rat

1996 ◽  
Vol 16 (12) ◽  
pp. 1516-1523 ◽  
Author(s):  
Johannes Waltenberger ◽  
M. Levent Akyürek ◽  
Magnus Aurivillius ◽  
Alkwin Wanders ◽  
Erik Larsson ◽  
...  
Keyword(s):  
Growth Factor ◽  
Transforming Growth Factor ◽  
Transforming Growth Factor Β ◽  
Observation Time ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
The Impact ◽  
Transplant Arteriosclerosis ◽  
Tgf Β1

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.

Do Donor Age and Cold-Ischemia Time Have a Detrimental Effect on Early Pancreas-Allograft Function?

Diabetes ◽  
1989 ◽  
Vol 38 (Supplement_1) ◽  
pp. 4-6 ◽  
Author(s):  
T. Schmid ◽  
A. KoNigsrainer ◽  
E. Steiner ◽  
J. Koller ◽  
R. Margreiter
Keyword(s):  
Detrimental Effect ◽  
Cold Ischemia Time ◽  
Donor Age ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
Allograft Function ◽  
Pancreas Allograft

MO942PREDICTORS OF DELAYED GRAFT FUNCTION IN KIDNEY TRANSPLANT RECIPIENTS THROUGHOUT 3 DECADES: A SINGLE-CENTER EXPERIENCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Carolina Figueiredo ◽  
Mariana Fernandes ◽  
Filipe Mira ◽  
Clara Pardinhas ◽  
Rita Leal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Graft Survival ◽  
Univariate Analysis ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Kidney Graft ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
The Impact

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.

scholarly journals Early morning kidney transplantation: Perioperative complications

2021 ◽  
Vol 93 (2) ◽  
pp. 158-161
Author(s):  
Mário Pereira Lourenço ◽  
Miguel Eliseu ◽  
Duarte Vieira Brito ◽  
João Carvalho ◽  
Edgar Tavares-Silva ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Perioperative Complications ◽  
Univariate Analysis ◽  
Early Morning ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Multivariate Statistical ◽  
Ischemia Time ◽  
Duration Of Surgery ◽  
The Impact

Introduction: To reduce cold ischemia time (CIT), many kidney transplants are performed in the early morning. Conducting complex surgeries in the early morning may influence the surgeon's technical capacity and rate of surgical complications (SC). Aim: Evaluate the influence of surgery start hour (SSH) regarding duration of surgery (DS), immediate diuresis (ID), SC and acute rejection (AR); evaluate the influence of CIT regarding SC, ID, and AR.Methods: 2855 cadaveric transplants performed between June 1980 and March 2018 were retrospectively evaluated. Regarding SSH, two groups were created: Group M (00: 00h-05.59h, n = 253) and Group D (06: 00h - 23: 59h, n = 2602). Analyzing the impact of SSH on DS, ID, SC and AR. Evaluate the relationship between CIT (< 18h, 18-30h and > 30h) on ID, SC and AR utilizing univariate and multivariate statistical analysis with SPSS. Results and Conclusion: Groups M and D were comparable in all evaluated demographic variables (p > 0.05), except cold ischemia time (Group M with higher CIT, p < 0.001). Regarding univariate analysis, Surgery start hour did not influence DS (p = 0.344), and SC (p = 0.264), but related with higher ID (p = 0.028) and AR (p = 0.018). CIT related with immediate diuresis (p = 0.020) and acute rejection (p < 0.001) but did not relate with complications (p = 0.734). Regarding multivariate analysis, SSH only influenced immediate diuresis (p = 0.026) and did not influenced acute rejection (p = 0.055). CIT influenced immediate diuresis (p = 0.019) and acute rejection (p < 0.001). Surgery start hour influences Immediate diuresis. With this study, we conclude that the priority must be a short cold ischemia time.

scholarly journals The endogenous capacity to produce proinflammatory mediators by the ex vivo human perfused lung

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Aleksandra Leligdowicz ◽  
James T. Ross ◽  
Nicolas Nesseler ◽  
Michael A. Matthay
Keyword(s):  
Ex Vivo ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Experimental Conditions ◽  
Ischemia Time ◽  
Proinflammatory Mediators ◽  
Donor Lung ◽  
Perfused Lung ◽  
Lung Response ◽  
Percent Weight Gain

Abstract Background The ex vivo human perfused lung model has enabled optimizing donor lungs for transplantation and delineating mechanisms of lung injury. Perfusate and airspace biomarkers are a proxy of the lung response to experimental conditions. However, there is a lack of studies evaluating biomarker kinetics during perfusion and after exposure to stimuli. In this study, we analyzed the ex vivo-perfused lung response to three key perturbations: exposure to the perfusion circuit, exogenous fresh whole blood, and bacteria. Results Ninety-nine lungs rejected for transplantation underwent ex vivo perfusion. One hour after reaching experimental conditions, fresh whole blood was added to the perfusate (n = 55). Two hours after reaching target temperature, Streptococcus pneumoniae was added to the perfusate (n = 42) or to the airspaces (n = 17). Perfusate and airspace samples were collected at baseline (once lungs were equilibrated for 1 h, but before blood or bacteria were added) and 4 h later. Interleukin (IL)-6, IL-8, angiopoietin (Ang)-2, and soluble tumor necrosis factor receptor (sTNFR)-1 were quantified. Baseline perfusate and airspace biomarker levels varied significantly, and this was not related to pre-procurement PaO2:FiO2 ratio, cold ischemia time, and baseline alveolar fluid clearance (AFC). After 4 h of ex vivo perfusion, the lung demonstrated a sustained production of proinflammatory mediators. The change in biomarker levels was not influenced by baseline donor lung characteristics (cold ischemia time, baseline AFC) nor was it associated with measures of experimental epithelial (final AFC) or endothelial (percent weight gain) injury. In the presence of exogenous blood, the rise in biomarkers was attenuated. Lungs exposed to intravenous (IV) bacteria relative to control lungs demonstrated a significantly higher rise in perfusate IL-6. Conclusions The ex vivo-perfused lung has a marked endogenous capacity to produce inflammatory mediators over the course of short-term perfusion that is not significantly influenced by donor lung characteristics or the presence of exogenous blood, and only minimally affected by the introduction of systemic bacteremia. The lack of association between biomarker change and donor lung cold ischemia time, final alveolar fluid clearance, and experimental percent weight gain suggests that the maintained ability of the human lung to produce biomarkers is not merely a marker of lung epithelial or endothelial injury, but may support the function of the lung as an immune cell reservoir.

IMPACT OF COLD ISCHEMIA TIME ON RENAL ALLOGRAFT OUTCOME FROM YOUNG DONORS

2008 ◽  
Vol 86 (Supplement) ◽  
pp. 364
Author(s):  
D Hernández ◽  
S Estupiñán ◽  
G Pérez Suárez ◽  
M Rufino ◽  
J M. González-Posada ◽  
...  
Keyword(s):  
Renal Allograft ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Ischemia Time ◽  
Allograft Outcome
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