Comparative analysis of risk factors in declined kidneys from donation after brain death and circulatory death
الباحث الأول:
Zinah Zwaini
الباحثين الآخرين:
Meeta Patel, Cordula Stover, John Dormer, Michael L Nicholson, Sarah A Hosgood, Bin Yang
المجلة:
Multidisciplinary Digital Publishing Institute
تاريخ النشر:
None
مختصر البحث:
Background and objectives:
Kidneys from donation after circulatory death (DCD) are more likely to be declined for transplantation compared with kidneys from donation after brain death (DBD). The aim of this study was to evaluate characteristics in …
Background and objectives:
Kidneys from donation after circulatory death (DCD) are more likely to be declined for transplantation compared with kidneys from donation after brain death (DBD). The aim of this study was to evaluate characteristics in the biopsies of human DCD and DBD kidneys that were declined for transplantation in order to rescue more DCD kidneys.
Materials and Methods:
Sixty kidney donors (DCD= 36, DBD= 24) were recruited into the study and assessed using donor demographics. Kidney biopsies taken post cold storage were also evaluated for histological damage, inflammation (myeloperoxidase, MPO), von Willebrand factor (vWF) expression, complement 4d (C4d) deposition and complement 3 (C3) activation using H&E and immunohistochemistry staining, and Western blotting.
Results:
More DBD donors (16/24) had a history of hypertension compared with DCDs (8/36, p= 0.001). The mean warm ischemic time in the DCD kidneys was 12.9±3.9 min. The mean cold ischemic time was not significantly different between the two groups of kidney donors (DBD 33.3±16.7 vs. DCD 28.6±14.1 h, p> 0.05). The score of histological damage and MPO, as well as the reactivity of vWF, C4d and C3, varied between kidneys, but there was no significant difference between the two donor types (p> 0.05). However, vWF reactivity might be an early indicator for loss of tissue integrity, while C4d deposition and activated C3 might be better predictors for histological damage.
