Agonal phase, ischaemic times, and renal vascular abnormalities and outcome of cadaver kidney transplants
A retrospective study of 250 cadaver kidney transplants was carried out to determine the effects of the agonal period, the warm and cold ischaemic times, and the use of kidneys with vascular anomalies on the primary success and failure and the subsequent level of function of the transplants. Kidneys...
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Published in | British Medical Journal Vol. 3; no. 5985; pp. 667 - 670 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
British Medical Journal Publishing Group
20.09.1975
British Medical Association BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
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Summary: | A retrospective study of 250 cadaver kidney transplants was carried out to determine the effects of the agonal period, the warm and cold ischaemic times, and the use of kidneys with vascular anomalies on the primary success and failure and the subsequent level of function of the transplants. Kidneys with vascular anomalies or from non-ventilated donors had a primary failure rate of over 30%, whereas those with normal vasculature or from ventilated donors had a rate of 17%. An initial warm ischaemic time of more than 60 minutes was associated with a primary failure rate of 57% and a cold ischaemic time of over 550 minutes with a primary failure rate of 47%. The interrelationship between the warm and cold ischaemic times in the primary success or failure of the transplants was examined and criteria defined for selecting potentially viable cadaver kidneys for transplantation, as follows: (1) The donor should be (a) ventilated, (b) aged 6-50 years, and (c) have normal ante-mortem renal function and have secreted more than 1-5 1 of urine in the 24 hours before death (or an equivalent volume if the urinary output was recorded for less than 24 hours before death); (2) the kidney should have normal renal vasculature enabling single arterial and venous anastomoses to be performed; (3) kidneys with I.W.I.T.s of longer than 60 minutes should not be used; (4) for kidneys with I.W.I.T.s of less than 20 minutes the C.I.T. is not critical but should not exceed 12 hours; (5) for kidneys with I.W.I.T.s of 20-60 minutes the C.I.T. should not exceed 450 minutes. |
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Bibliography: | istex:0C5F1727B7F98F0AA2D245CFFFC9752B2CC04D53 ark:/67375/NVC-XPHR6JTK-G href:bmj-3-667.pdf local:bmj;3/5985/667 PMID:1100186 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0007-1447 1468-5833 |
DOI: | 10.1136/bmj.3.5985.667 |