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Impact of spontaneous donor hypothermia on graft outcomes after kidney transplantation

A previous donor intervention trial found that therapeutic hypothermia reduced delayed graft function (DGF) after kidney transplantation. This retrospective cohort study nested in the randomized dopamine trial (ClinicalTrials.gov identifier: NCT000115115) investigates the effects of spontaneous dono...

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Main Authors: Schnülle, Peter (Author) , Mundt, Heiko (Author) , Drüschler, Felix (Author) , Schmitt, Wilhelm (Author) , Yard, Benito A. (Author) , Krämer, Bernhard (Author) , Benck, Urs Tobias (Author)
Format: Article (Journal)
Language:English
Published: 2018
In: American journal of transplantation
Year: 2017, Volume: 18, Issue: 3, Pages: 704-714
ISSN:1600-6143
DOI:10.1111/ajt.14541
Online Access:Verlag, Volltext: http://dx.doi.org/10.1111/ajt.14541
Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.14541
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Author Notes:P. Schnuelle, H.M. Mundt, F. Drüschler, W.H. Schmitt, B.A. Yard, B.K. Krämer, U. Benck
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Summary:A previous donor intervention trial found that therapeutic hypothermia reduced delayed graft function (DGF) after kidney transplantation. This retrospective cohort study nested in the randomized dopamine trial (ClinicalTrials.gov identifier: NCT000115115) investigates the effects of spontaneous donor hypothermia (core body temperature <36°C) on initial kidney graft function, and evaluates 5-year graft survival. Hypothermia assessed by a singular measurement in the intensive care unit 4-20 hours before procurement was associated with less DGF after kidney transplantation (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.34-0.91). The benefit was greater when need for more than a single posttransplant dialysis session was analyzed (OR 0.48, 95%CI 0.28-0.82). Donor dopamine ameliorated dialysis requirement independently from hypothermia in a temporal relationship with exposure (OR 0.93, 95%CI 0.87-0.98, per hour). A lower core body temperature in the donor was associated with lower serum creatinine levels before procurement, which may reflect lower systemic inflammation and attenuated renal injury from brain death. Despite a considerable effect on DGF, our study failed to demonstrate a graft survival advantage (hazard ratio [HR] 0.83, 95%CI 0.54-1.27), whereas dopamine treatment was associated with improved long-term outcome (HR 0.95, 95%CI 0.91-0.99 per hour).
Item Description:Gesehen am 04.07.2018
Physical Description:Online Resource
ISSN:1600-6143
DOI:10.1111/ajt.14541

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