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Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
Extraction time of kidneys during organ procurement impacts function
1Division of Transplantation, Department of Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ, USA. adena.osband@rwjuh.edu
Clinical Transplantation
|April 14, 2010
Summary
Extraction time, the period between aortic cross-clamp and kidney removal, significantly impacts kidney transplant success. Shorter extraction times correlate with reduced early graft failure and improved recovery from delayed graft function.
Area of Science:
- Nephrology
- Transplant Surgery
- Organ Preservation
Background:
- Ischemic time is a known factor influencing kidney transplant outcomes.
- Limited data exists on the impact of extraction time on deceased donor kidney transplants.
- Extraction time, defined as the interval from aortic cross-clamp to organ cooling and removal, is a potential modifiable factor.
Purpose of the Study:
- To investigate the association between extraction time and kidney transplant outcomes.
- To determine if extraction time is an independent risk factor for delayed graft function (DGF) and graft failure.
- To evaluate the impact of extraction time on post-transplant kidney function.
Main Methods:
- Retrospective analysis of 316 deceased donor kidney transplants (excluding en bloc and donation after cardiac death cases).
- Data pooled from May 2003 to December 2004 from Gift of Life OPO and UNOS.
- Statistical analysis of donor, recipient, and transplant characteristics, focusing on extraction time intervals.
Main Results:
- Extraction time directly correlated with early graft failure (Spearman's rank correlation, p < 0.05).
- Extraction time intervals of 30 minutes showed increasing rates of graft failure (0%, 8.1%, 14.5%).
- Delayed graft function (DGF) rates were not directly linked to extraction time, but shorter times improved DGF recovery and function.
Conclusions:
- Extraction time represents an additional insult in kidney transplantation.
- Shorter extraction times are associated with better graft survival and functional recovery.
- Further research is warranted to elucidate the precise impact of extraction time on transplant outcomes.
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