Impact of Extraction Time during Donation after Circulatory Death Organ Procurement on Kidney Function after Transplantation in the Netherlands

Erika Van Straalen*, Elsaline Rijkse, Anneloes Van Staa, Paul M. Rebers, Hanneke J.A.M. Hagenaars, Jacqueline Van De Wetering, Jan N.M. Ijzermans, Robert C. Minnee

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

14 Downloads (Pure)

Abstract

Background:

In The Netherlands, 60% of deceased-donor kidney offers are after donation after circulatory death. Cold and warm ischemia times are known risk factors for delayed graft function (DGF) and inferior allograft survival. Extraction time is a relatively new ischemia time. During procurement, cooling of the kidneys is suboptimal with ongoing ischemia. However, evidence is lacking on whether extraction time has an impact on DGF if all ischemic periods are included.

Methods:

Between 2012 and 2018, 1524 donation after circulatory death kidneys were procured and transplanted in The Netherlands. Donation and transplantation-related data were obtained from the database of the Dutch Transplant Foundation. The primary outcome parameter was the incidence of DGF. 

Results:

In our cohort, extraction time ranged from 14 to 237 min, with a mean of 62 min (SD 32). In multivariate logistic regression analysis, extraction time was an independent risk factor for incidence of DGF (odds ratio per minute increase 1.008; 95% confidence interval, 1.003-1.013; P = 0.001). The agonal phase, hypoperfusion time, and anastomosis time were not independent risk factors for incidence of DGF. 

Conclusions:

Considering all known ischemic periods during the donation after the circulatory death process, prolonged kidney extraction time increased the risk of DGF after kidney transplantation.

Original languageEnglish
Article numberE1538
JournalTransplantation Direct
Volume9
Issue number11
DOIs
Publication statusPublished - Nov 2023

Bibliographical note

Publisher Copyright:
© 2023 Wolters Kluwer Health. All rights reserved.

Fingerprint

Dive into the research topics of 'Impact of Extraction Time during Donation after Circulatory Death Organ Procurement on Kidney Function after Transplantation in the Netherlands'. Together they form a unique fingerprint.

Cite this