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首页> 外文期刊>American journal of transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Surgeons >Cold ischemia time and allograft outcomes in live donor renal transplantation: is live donor organ transport feasible?
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Cold ischemia time and allograft outcomes in live donor renal transplantation: is live donor organ transport feasible?

机译：活体供体肾移植中的冷缺血时间和同种异体移植结果：活体供体器官运输可行吗？

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摘要

One of the greatest obstacles to the implementation of regional or national kidney paired donation programs (KPD) is the need for the donor to travel to their matched recipient's hospital. While transport of the kidney is an attractive alternative, there is concern that prolonged cold ischemia time (CIT) would diminish the benefits of live donor transplantation (LDTx). To examine the impact of increased CIT in LDTx, 1-year serum creatinine (SCr), delayed graft function (DGF), acute rejection (AR) and allograft survival (AS) were analyzed in 38 467 patients by 2 h CIT groups (0-2, 2-4, 4-6 and 6-8 h) using data from the United Network for Organ Sharing/Organ Procurement and Transplantation Network (UNOS/OPTN). Adjusted probabilities of DGF and AR were estimated in multivariate logistic regression models and AS was examined in multivariate Cox proportional hazards models. Although some increase in DGF was observed between the 0-2 h (4.7%) and 4-6 h (8.3%) groups, prolonged CIT did not result in inferior SCr, increased AR or compromised AS in any group with >2 h CIT compared with the 0-2 h group. Comparable long-term outcomes for these grafts suggests that transport of live donor organs may be a feasible alternative to donor travel in KPD regions where CIT can be limited to 8 h.
机译：实施地区或国家肾脏配对捐赠计划（KPD）的最大障碍之一是捐赠者需要前往与其配对的接受者的医院。尽管肾脏运输是一种有吸引力的替代方法，但人们担心延长的冷缺血时间（CIT）将削弱活体供体移植（LDTx）的益处。为了检查CIT增加对LDTx的影响，对2 h CIT组的38 467名患者进行了1年期血清肌酐（SCr），延迟移植功能（DGF），急性排斥反应（AR）和同种异体移植存活（AS）的分析（0 -2、2-4、4-6和6-8小时）使用来自器官共享/器官采购和移植网络（UNOS / OPTN）联合网络的数据。在多元logistic回归模型中估计了DGF和AR的调整后概率，在多元Cox比例风险模型中检查了AS。尽管在0-2 h（4.7％）和4-6 h（8.3％）组之间观察到DGF有所增加，但CIT> 2 h的任何组中延长的CIT均不会导致SCr降低，AR升高或AS受损与0-2 h组相比。这些移植物的可比较的长期结果表明，活体供体器官的运输可能是在CIT限于8小时的KPD地区进行供体旅行的可行替代方案。

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