Evolution and results of kidney transplantation with donors in asystole
Manuel Rengel1, Lorena Tana1, Facundo Humacata1, Soraya Abad1, Almudena Vega1, Úrsula Verdalles1, Eduardo Verde1.
1Nephrology, Hospital General Universitario "Gregorio Marañón", Madrid, Spain
Introduction: Before the introduction of the concept of brain death, organs for transplantation were obtained from donors in asystole Some transplant programs arouse the interest by these types of donors for increasing the number of kidney transplants. We analyze the evolution and results of kidney transplants performed in our hospital with asystole donors.
Patients: Eighty patients were transplanted with kidneys from donors in asystole, 60 with type II and 20 with Type III Maastricht. This group was compared with recipients of with heart beating donors with similar age, sex, number of transplants and HLA matching. Immunosuppression was performed with Prednisone, Tacrolimus and Mycophenolate. The induction was done with ATG-Fresenius or Basiliximab. Acute rejection crises were treated with boluses of Methylprednisolone. ATG-Fresenius was used in corticoresistant rejections.
Results: Delayed graft function was more common in asystole donors compared to heart beating donors. Plasma creatinine concentration was significantly better in asystole donors, 1.5 mg/dl versus 1.7 mg/dl. Graft survival was 86% at five years in asystole donor and 88% in heart beating donors Patient survival was 100% in both groups. Hospitalization of asystole donors recipients was longer and they required more hemodialysis sessions. Acute rejection crises were more frequent in asystole donors recipients.
Conclusions: Transplants performed with asystole donors have similar kidney function and survival compared to heart beating donors. Asystole donors can help to increase kidney transplants.