PMID- 17297393
OWN - NLM
STAT- MEDLINE
DCOM- 20070326
LR  - 20220408
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 83
IP  - 3
DP  - 2007 Feb 15
TI  - Multicenter analysis of kidney preservation.
PG  - 247-53
AB  - BACKGROUND: Kidney preservation is an integral part of clinical kidney 
      transplantation. Changes in the use of preservation methods and storage 
      solutions, ischemic preservation times, and the relationship between ischemia 
      time and human leukocyte antigen (HLA) match have not been extensively studied in 
      recent years. METHODS: The Collaborative Transplant Study database was used to 
      analyze effects of kidney preservation methods and times. Graft survival and 
      death-censored functional survival were used as endpoints. In all, 91,674 
      transplants from deceased donors were analyzed using univariate and multivariate 
      methods. RESULTS: Cold storage accounted for more than 95% of kidney 
      preservations from 1990-2005. Increasing ischemia up to 18 hr was not detrimental 
      for graft outcome, whereas the risk of graft failure rose with ischemia 19-24 hr 
      to relative risk (RR) 1.09, 25-36 hr to RR 1.16, and >36 hr to RR 1.30 (P<0.001). 
      As compared to other preservation solutions, University of Wisconsin (UW) 
      solution was associated with significantly better outcome when ischemia exceeded 
      24 hr. Short ischemia did not eliminate the effect of HLA matching. Kidneys from 
      young or old donors were affected by prolonged ischemia to similar degrees. 
      Pulsatile machine perfusion was not superior to cold storage. CONCLUSION: Kidneys 
      from deceased donors should ideally be transplanted within 18 hr. Within the 
      18-hr window, the time of ischemia has no significant influence on graft 
      survival. UW solution should be used if preservation for longer periods is 
      envisioned. HLA matching improves graft survival regardless of length of 
      ischemia.
FAU - Opelz, Gerhard
AU  - Opelz G
AD  - Department of Transplantation Immunology, Institute of Immunology, University of 
      Heidelberg, Germany. gerhard.opelz@med.uni-heidelberg.de
FAU - Dohler, Bernd
AU  - Dohler B
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (HLA-A Antigens)
RN  - 0 (Organ Preservation Solutions)
SB  - IM
CIN - Transplantation. 2007 Feb 15;83(3):254. PMID: 17297394
CIN - Transplantation. 2007 Feb 15;83(3):255-6. PMID: 17297395
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - *Cold Ischemia
MH  - Female
MH  - *Graft Survival/drug effects
MH  - HLA-A Antigens/analysis
MH  - Histocompatibility
MH  - Humans
MH  - *Kidney
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Organ Preservation/*methods
MH  - Organ Preservation Solutions/pharmacology
MH  - Tissue Donors
EDAT- 2007/02/14 09:00
MHDA- 2007/03/27 09:00
CRDT- 2007/02/14 09:00
PHST- 2007/02/14 09:00 [pubmed]
PHST- 2007/03/27 09:00 [medline]
PHST- 2007/02/14 09:00 [entrez]
AID - 00007890-200702150-00001 [pii]
AID - 10.1097/01.tp.0000251781.36117.27 [doi]
PST - ppublish
SO  - Transplantation. 2007 Feb 15;83(3):247-53. doi: 
      10.1097/01.tp.0000251781.36117.27.