DONORS WITH CARDIAC DEATH: FULL RESOURCE OF KIDNEY TRANSPLANTATION

THE AIM. To offer procurement society reliable protocol of full kidney transplants from donors with heart death based on 5-year results of kidney transplants received via protocol normothermic hemoperfusion with extracorporeal oxygenation. PATIENTS AND METHODS. The study included 29 DCD kidneys (primary warm ischemic time – 58,1 (19,39) minutes), received with use of suggested protocol and estimated results of such grafts transplantation to 58 recipients. Received data were validated by comparison with outcomes of 112 kidney transplantations from 115 brain death donors (BDDs). RESULTS. In study group IGF was observed in 28 (48.3%) of the 58 recipients, in control group – 63,4% (71 recipient). There were 4 cases of PNFT, these patients were not included into study group. The actuarial 5-year graft survival rate was 82,8% (n=48) as contrasted with 87,5% (n=98) (BDDs) (p>0,05). Serum creatinine levels over 5 years after transplantation were 0,094(0,06)mmol/l in recipients of DCD kidneys and 0,103(0,07)mmol/l – BDD kidneys (p>0,05). CONCLUSION. Reconstruction and survival of procurement organs from unexpectedly died persons with critical asystole period with extracorporeal perfusion in situ is promising protocol. Use of thrombolytics and mechanical perfused removal of leukothromboagglomerates formed during lack of blood circulation are necessary. The 5-years outcomes of kidney transplantation received from DCD with use of extracorporeal perfusion in situ did not differ from outcomes of kidney transplantation from BDDs.

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