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Kidney donation after circulatory death in a country with a high number of brain dead donors: 10-year experience in Belgium

(2012) TRANSPLANT INTERNATIONAL. 25(8). p.857-866
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Organization
Abstract
Worldwide shortage of standard brain dead donors (DBD) has revived the use of kidneys donated after circulatory death (DCD). We reviewed the Belgian DCD kidney transplant (KT) experience since its reintroduction in 2000. Risk factors for delayed graft function (DGF) were identified using multivariate analysis. Five-year patient/graft survival was assessed using KaplanMeier curves. The evolution of the kidney donor type and the impact of DCDs on the total KT activity in Belgium were compared with the Netherlands. Between 2000 and 2009, 287 DCD KT were performed. Primary nonfunction occurred in 1% and DGF in 31%. Five-year patient and death-censored graft survival were 93% and 95%, respectively. In multivariate analysis, cold storage (versus machine perfusion), cold ischemic time, and histidine-tryptophan-ketoglutarate solution were independent risk factors for the development of DGF. Despite an increased number of DCD donations and transplantations, the total number of deceased KT did not increase significantly. This could suggest a shift from DBDs to DCDs. To increase KT activity, Belgium should further expand controlled DCD programs while simultaneously improve the identification of all potential DBDs and avoid their referral for donation as DCDs before brain death occurs. Furthermore, living donation remains underused.
Keywords
donation after circulatory death, delayed graft function, donation programs, kidney transplantation, risk factors, HEART-BEATING DONORS, CARDIAC DEATH, MACHINE PERFUSION, ORGAN DONATION, COLD-STORAGE, RENAL-TRANSPLANTATION, EUROPEAN COUNTRIES, CONTROLLED-TRIAL, UNITED-STATES, LONG, Belgium

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MLA
Jochmans, Ina, Tom Darius, Dirk Kuypers, et al. “Kidney Donation After Circulatory Death in a Country with a High Number of Brain Dead Donors: 10-year Experience in Belgium.” TRANSPLANT INTERNATIONAL 25.8 (2012): 857–866. Print.
APA
Jochmans, I., Darius, T., Kuypers, D., Monbaliu, D., Goffin, E., Mourad, M., Ledinh, H., et al. (2012). Kidney donation after circulatory death in a country with a high number of brain dead donors: 10-year experience in Belgium. TRANSPLANT INTERNATIONAL, 25(8), 857–866.
Chicago author-date
Jochmans, Ina, Tom Darius, Dirk Kuypers, Diethard Monbaliu, Eric Goffin, Michel Mourad, Hieu Ledinh, et al. 2012. “Kidney Donation After Circulatory Death in a Country with a High Number of Brain Dead Donors: 10-year Experience in Belgium.” Transplant International 25 (8): 857–866.
Chicago author-date (all authors)
Jochmans, Ina, Tom Darius, Dirk Kuypers, Diethard Monbaliu, Eric Goffin, Michel Mourad, Hieu Ledinh, Laurent Weekers, PATRICK PEETERS, Caren Randon, Jean-Louis Bosmans, Geert Roeyen, Daniel Abramowicz, Anh-Dung Hoang, Luc De Pauw, Axel Rahmel, Jean-Paul Squifflet, and Jacques Pirenne. 2012. “Kidney Donation After Circulatory Death in a Country with a High Number of Brain Dead Donors: 10-year Experience in Belgium.” Transplant International 25 (8): 857–866.
Vancouver
1.
Jochmans I, Darius T, Kuypers D, Monbaliu D, Goffin E, Mourad M, et al. Kidney donation after circulatory death in a country with a high number of brain dead donors: 10-year experience in Belgium. TRANSPLANT INTERNATIONAL. 2012;25(8):857–66.
IEEE
[1]
I. Jochmans et al., “Kidney donation after circulatory death in a country with a high number of brain dead donors: 10-year experience in Belgium,” TRANSPLANT INTERNATIONAL, vol. 25, no. 8, pp. 857–866, 2012.
@article{5722716,
  abstract     = {Worldwide shortage of standard brain dead donors (DBD) has revived the use of kidneys donated after circulatory death (DCD). We reviewed the Belgian DCD kidney transplant (KT) experience since its reintroduction in 2000. Risk factors for delayed graft function (DGF) were identified using multivariate analysis. Five-year patient/graft survival was assessed using KaplanMeier curves. The evolution of the kidney donor type and the impact of DCDs on the total KT activity in Belgium were compared with the Netherlands. Between 2000 and 2009, 287 DCD KT were performed. Primary nonfunction occurred in 1% and DGF in 31%. Five-year patient and death-censored graft survival were 93% and 95%, respectively. In multivariate analysis, cold storage (versus machine perfusion), cold ischemic time, and histidine-tryptophan-ketoglutarate solution were independent risk factors for the development of DGF. Despite an increased number of DCD donations and transplantations, the total number of deceased KT did not increase significantly. This could suggest a shift from DBDs to DCDs. To increase KT activity, Belgium should further expand controlled DCD programs while simultaneously improve the identification of all potential DBDs and avoid their referral for donation as DCDs before brain death occurs. Furthermore, living donation remains underused.},
  author       = {Jochmans, Ina and Darius, Tom and Kuypers, Dirk and Monbaliu, Diethard and Goffin, Eric and Mourad, Michel and Ledinh, Hieu and Weekers, Laurent and Peeters, Patrick and Randon, Caren and Bosmans, Jean-Louis and Roeyen, Geert and Abramowicz, Daniel and Hoang, Anh-Dung and De Pauw, Luc and Rahmel, Axel and Squifflet, Jean-Paul and Pirenne, Jacques},
  issn         = {0934-0874},
  journal      = {TRANSPLANT INTERNATIONAL},
  keywords     = {donation after circulatory death,delayed graft function,donation programs,kidney transplantation,risk factors,HEART-BEATING DONORS,CARDIAC DEATH,MACHINE PERFUSION,ORGAN DONATION,COLD-STORAGE,RENAL-TRANSPLANTATION,EUROPEAN COUNTRIES,CONTROLLED-TRIAL,UNITED-STATES,LONG,Belgium},
  language     = {eng},
  number       = {8},
  pages        = {857--866},
  title        = {Kidney donation after circulatory death in a country with a high number of brain dead donors: 10-year experience in Belgium},
  url          = {http://dx.doi.org/10.1111/j.1432-2277.2012.01510.x},
  volume       = {25},
  year         = {2012},
}

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