PDF(Pubmed)
Abstract：
This study evaluated the current practices of selecting cold storage preservation solutions in Brazil and their impact on delayed graft function (DGF) incidence and 1-year outcomes in kidney transplant recipients. A retrospective cohort study was conducted, including 3,134 brain-dead deceased donor kidney transplants performed between 2014 and 2015 in 18 Brazilian centers. The most commonly used preservation solution was Euro-collins (EC, 55.4%), followed by Histidine-tryptophan-ketoglutarate (HTK, 30%) and Institut Georges Lopez (IGL-1, 14.6%). The incidence of DGF was 54.4%, with 11.7% of patients requiring dialysis for more than 14 days, indicating prolonged DGF. Upon adjusting for confounding variables, HTK demonstrated a significantly lower risk of DGF than EC (OR 0.7350.82500.926), as did IGL-1 (OR 0.6050.7120.837). Similar protective effects were observed for prolonged DGF when comparing HTK (OR 0.4780.5990.749) and IGL-1 (OR 0.4780.6810.749) against EC. No significant association was found between preservation solutions and 1-year death-censored graft survival. In conclusion, EC was the most frequently used cold storage perfusion solution, demonstrating a higher incidence and duration of DGF compared with HTK and IGL-1, but with no impact on 1-year graft survival.
摘要：
这项研究评估了巴西目前选择冷藏保存解决方案的做法及其对肾移植受者延迟移植功能（DGF）发生率和1年预后的影响。进行了一项回顾性队列研究，包括2014年至2015年期间在18个巴西中心进行的3,134例脑死亡的死者供体肾脏移植。最常用的保存溶液是Euro-collins(EC，55.4%），其次是组氨酸-色氨酸-酮戊二酸(HTK，30%)和乔治·洛佩兹研究所(IGL-1，14.6%)。DGF的发生率为54.4%,11.7%的患者需要透析超过14天，表明DGF延长。在调整混杂变量后，HTK显示DGF的风险明显低于EC（OR0.7350.82500.926），IGL-1也是如此（或0.605.7120.837）。当比较HTK(OR0.4780.5990.749)和IGL-1(OR0.4780.6810.749)与EC时,对于延长的DGF观察到类似的保护作用。在保存解决方案和1年死亡审查的移植物存活率之间没有发现显着关联。总之,EC是最常用的冷藏灌注溶液，与HTK和IGL-1相比，DGF的发生率和持续时间更高，但对1年移植物存活率没有影响。
