2266 ASSESSMENT OF EGFR AND ONE-HOUR BIOPSY USING IN-SITU-COOLING DOUBLE-BALLOON CATHETERS IN DECEASED KIDNEY TRANSPLANTS

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Vascular Surgery II1 Apr 20122266 ASSESSMENT OF EGFR AND ONE-HOUR BIOPSY USING IN-SITU-COOLING DOUBLE-BALLOON CATHETERS IN DECEASED KIDNEY TRANSPLANTS Kazuo Mizutani, Ryohei Hattori, Tsuneo Kinukawa, Osamu Kamihira, and Momokazu Gotoh Kazuo MizutaniKazuo Mizutani Nagoya, Aichi, Japan More articles by this author , Ryohei HattoriRyohei Hattori Nagoya, Japan More articles by this author , Tsuneo KinukawaTsuneo Kinukawa Nagoya, Japan More articles by this author , Osamu KamihiraOsamu Kamihira Komaki, Japan More articles by this author , and Momokazu GotohMomokazu Gotoh Nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2444AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The shortage of deceased donor kidneys for transplantation has become a worldwide issue in the past decades. However, both availability and feasibility of marginal deceased donor kidneys are still problematic. To increase donor pool and improve results, we created a specially designed in-situ cooling system. The purpose of this study was to estimate availability of deceased donor kidneys, analyze donor one-hour biopsy, and better evaluate methods to estimate donor/recipient kidney function other than using donor Cr, comparing with living related transplants. METHODS We studied 129 deceased renal transplant recipients (DD) who received kidneys from non-heart-beating donors beginning in 1984. Calcineurin Inhibitors were given to all transplants. Donors were in Maastricht Donor Categories III and IV and to minimize warm ischemic kidney damage we performed in situ cooling with specially designed double-balloon catheters. One-hour biopsies were analyzed with Remuzzi's evaluation system, and were scored for histological assessment. Twenty-nine living-related transplants (LD) were a control group. RESULTS In the DD group average donor Cr and eGFR levels at admission were 0.3-2.1mg/dl (ave. 1.0) and 24-138 ml/min/1.73 (ave. 67) and levels before death were 0.3-15.9 (2.7) and 4-164 (34). Average recipient Cr and eGFR levels at discharge were 0.3-5.3 (1.8) and .10-133 (39). Although average donor Cr levels before death were high, the DD had good function using our catheter system. To define kidney function after transplant, the DD were classified according to recipient eGFR at discharge: <25 ml/min/1.73 for the poor function group (PF: n=32) and >25 for the good function group (GF: n=95). GF had higher eGFR levels at donor hospital admission than the PF (p=0.005). There was no statistically significant difference in Cr levels of donor (at admission and before death) between those groups. Pathologically, the DD with less glomerular sclerosis of 1-hour biopsies had better graft survival than damaged subjects (p=0.015). Other histological scores were not associated with kidney survival. In mild-damaged histological scores, discharge-eGFR levels of DD and LD were the same with no statistically significant difference, although DD had poorer function than LD in less-damaged scores. CONCLUSIONS Deceased kidney transplants had excellent renal function with our double balloon catheter system. Donor Cr levels were not a useful measurement for our analysis, but eGFR and 1-hour biopsy should be used for donor evaluation and transplant renal function. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e914 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kazuo Mizutani Nagoya, Aichi, Japan More articles by this author Ryohei Hattori Nagoya, Japan More articles by this author Tsuneo Kinukawa Nagoya, Japan More articles by this author Osamu Kamihira Komaki, Japan More articles by this author Momokazu Gotoh Nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...