期刊
JOURNAL OF CRITICAL CARE
卷 25, 期 4, 页码 582-590出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2010.02.011
关键词
Brain death; Organ donor; Delayed graft function; H1 Nuclear magnetic resonance; Ischemia reperfusion; Renal transplantation
资金
- PHRC regional from CHU de Poitiers
Purpose The aim of this study was to analyze the importance of donor factors and especially the potential role of hemodynamic management in regard to delayed graft function in paired kidney recipient patients after renal transplantation and to analyze the urine of organ donors by proton-nuclear magnetic resonance spectroscopy to identify urine markers potentially correlated with delayed graft function in recipient patients Methods A prospective multicenter epidemiologic study was conducted A logistic regression model taking into account paired data was used Results Data from 72 donors and the 144 corresponding paired recipients were analyzed Univariate analysis showed that age of donor previous history of tobacco ischemic cause of brain death, norepinephrine infusion, and recipient age were the risk factors for delayed graft function After adjusting for correlated outcome data and controlling for other potential prognostic factors 3 variables remained significantly associated with outcome donor age (odds ratio [OR], 10 7), hemodynamic status (OR 0 167), and hydroxyl ethyl starch infusion (OR, 0 135) Proton-nuclear magnetic resonance analysis evidenced 3 metabolites of interest in donors (trimethylamine N oxide, citrate, and lactate) However, these peaks were not correlated the clinical parameters in donors Conclusions Paired analysis of kidney transplantation emphasizes the important role of factor donor associated with delayed graft function in recipient Thus, a particular attention should be paid to the hemodynamic management of donor (C) 2010 Elsevier Inc All rights reserved
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