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130. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

30.04. - 03.05.2013, München

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Significant Impact of Prolonged Brain Death Duration on Patient Survival after Kidney Transplantation

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  • Annemarie Weißenbacher - Medizinische Universität Innsbruck, Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Innsbruck
  • Rupert Oberhuber - Medizinische Universität Innsbruck, Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Innsbruck
  • Sascha Weiß - Medizinische Universität Innsbruck, Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Innsbruck
  • Benno Cardini - Medizinische Universität Innsbruck, Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Innsbruck
  • Claudia Bösmüller - Medizinische Universität Innsbruck, Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Innsbruck
  • Stefan Schneeberger - Medizinische Universität Innsbruck, Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Innsbruck
  • Johann Pratschke - Medizinische Universität Innsbruck, Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Innsbruck
  • Robert Öllinger - Medizinische Universität Innsbruck, Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Innsbruck

Deutsche Gesellschaft für Chirurgie. 130. Kongress der Deutschen Gesellschaft für Chirurgie. München, 30.04.-03.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13dgch146

doi: 10.3205/13dgch146, urn:nbn:de:0183-13dgch1469

Published: April 26, 2013

© 2013 Weißenbacher et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: In renal transplantation, graft survival using organs from deceased kidney donors is inferior to results after living donation. However, little is known about the effect of brain death duration (BDdur) on long term outcome after kidney transplantation (KTx).

Material and methods: A single-center retrospective analysis of 1245 consecutive deceased donor KTx, carried out between January 2000 and December 2010, was performed. BDdur was calculated as the period between brain death declaration and start of cold perfusion. All recipient-, donor- and transplant-factors, known at the timepoint of KTx, were investigated for their impact on delayed graft function (DGF), acute rejection (AR), „graft loss“ and „death“. Uni- and multivariate statistical analysis were done using binary logistic- and Cox-regression analysis.

Results: Mean BDdur was 12.01 ± 6.26 hours. Recipients which developed DGF received organs from deceased donors with a significant longer BDdur; 12.13 ± 5.815 vs. 11.82 ± 6.177 hours, p=0.0034. BDdur correlated with the occurence of AR inversely, without reaching significance; AR 11.85 ± 6.33 hours vs.12.04 ± 5.997 hours no AR, p=0.156. BDdur did not affect the graft survival, but had a significant impact on patient survival. Beside recipient´s age, BDdur was the most important independent factor for „death“ after KTx; Hazard Ratio (95%CI): 1.041 (1.015-1.067); p=0.002.

Conclusion: BDdur has a significant impact on long term survival after kidney transplantation. This finding represents the importance of optimizing time management prior and during organ retrieval procedures.