Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.24915/aup.36.1-2.86 |
Resumo: | Introduction: Chronic kidney disease is a prevalent disorder, with a significant number of late stage patients, which only options are renal replacement therapy and transplantation. Kidney transplantation is associated with higher quality of life and lower mortality. The increasing gap between the demand for kidneys and its availability for transplantation has prompted the research and development of an alternative source to the conventional brain dead donors, the donors after cardiac death. The latter need preservation techniques in order to offer similar functional results. In the present article, we proposed to review the recent evidence about the role of extracorporeal membrane oxygenation as preservation technique in the harvesting of kidneys from donors after circulatory death. Material and Methods: A literature research was conducted in PubMed/MEDLINE, using the following expressions: “kidney transplantation”; “non-heart-beating donor”; “donation after cardiac death”; “extracorporeal membrane oxygenation”; “abdominal normothermic perfusion”. Based on the selected articles, it was performed a non-systematic review, summarizing the recent evidence about the role of extracorporeal membrane oxygenation as preservation technique in the harvesting of kidneys from donors after circulatory death. Results: The evidence suggests that extracorporeal membrane oxygenation is better than the other preservation techniques used in donors after cardiac death, as it has been associated to improved renal allograft outcomes. Regarding the conventional deceased donors, the brain dead, this technique allows similar results, particularly when compared with expanded criteria donors. Discussion: Organ preservation through extracorporeal membrane oxygenation in cardiac death donors has favorable functional results and, for this reason, may contribute to increase the pool of donors. The logistical challenges of the technique restrict its implementation. Conclusion: In the long-term, should be created conditions so that extracorporeal membrane oxygenation in donors after cardiac death may be widely implemented, increasing the number of kidneys obtained for transplantation. |
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Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane OxygenationDoação de Rins Após Paragem Cardiocirculatória: O Papel da Oxigenação por Membrana ExtracorporalCoronary CirculationDeathDonor SelectionExtracorporeal Membrane OxygenationGraft SurvivalKidney TransplantationOrgan PreservationCirculação CoronáriaOxigenação por Membrana ExtracorpóreaMortePreservação de OrgãoSeleção do DoadorSobrevivência de EnxertoTransplante de RimIntroduction: Chronic kidney disease is a prevalent disorder, with a significant number of late stage patients, which only options are renal replacement therapy and transplantation. Kidney transplantation is associated with higher quality of life and lower mortality. The increasing gap between the demand for kidneys and its availability for transplantation has prompted the research and development of an alternative source to the conventional brain dead donors, the donors after cardiac death. The latter need preservation techniques in order to offer similar functional results. In the present article, we proposed to review the recent evidence about the role of extracorporeal membrane oxygenation as preservation technique in the harvesting of kidneys from donors after circulatory death. Material and Methods: A literature research was conducted in PubMed/MEDLINE, using the following expressions: “kidney transplantation”; “non-heart-beating donor”; “donation after cardiac death”; “extracorporeal membrane oxygenation”; “abdominal normothermic perfusion”. Based on the selected articles, it was performed a non-systematic review, summarizing the recent evidence about the role of extracorporeal membrane oxygenation as preservation technique in the harvesting of kidneys from donors after circulatory death. Results: The evidence suggests that extracorporeal membrane oxygenation is better than the other preservation techniques used in donors after cardiac death, as it has been associated to improved renal allograft outcomes. Regarding the conventional deceased donors, the brain dead, this technique allows similar results, particularly when compared with expanded criteria donors. Discussion: Organ preservation through extracorporeal membrane oxygenation in cardiac death donors has favorable functional results and, for this reason, may contribute to increase the pool of donors. The logistical challenges of the technique restrict its implementation. Conclusion: In the long-term, should be created conditions so that extracorporeal membrane oxygenation in donors after cardiac death may be widely implemented, increasing the number of kidneys obtained for transplantation.Introdução: A doença renal crónica é uma patologia prevalente, sendo significativo o número de doentes em estádio terminal cujas alternativas se resumem à terapêutica de substituição da função renal e ao transplante, sendo o último associado a maior qualidade de vida e a menor mortalidade. A procura crescente de rins para transplante tem aumentado o desfasamento relativamente aos rins disponíveis. Esse desfasamento impulsionou a pesquisa e desenvolvimento de alternativas aos dadores cadáver em morte cerebral, sendo os dadores após paragem cardiocirculatória uma alternativa viável. Estes obrigam a técnicas de preservação de órgão distintas, de forma a poder oferecer resultados funcionais sobreponíveis. O objetivo deste artigo foi rever a evidência recente sobre o papel da utilização da oxigenação por membrana extracorporal como técnica de preservação, na colheita de rins de dadores após paragem cardiocirculatória. Material e Métodos: Foi efectuada uma pesquisa na base PubMed/MEDLINE, utilizando as expressões: “kidney transplantation”; “non-heart-beating donor”; “donation after cardiac death”; “extracorporeal membrane oxygenation”; “abdominal normothermic perfusion”. Com os artigos selecionados, realizou- se uma revisão não sistemática, sumarizando a evidência recente sobre a utilização da oxigenação por membrana extracorporal na colheita de rins de dadores após paragem cardiocirculatória. Resultados: Verificou-se que os estudos sugerem com unanimidade que a oxigenação por membrana extracorporal é superior às outras técnicas de preservação utilizadas em dadores após paragem cardiocirculatória, uma vez que está associada a melhores resultados a curto prazo do aloenxerto renal. Relativamente aos dadores convencionais, em morte cerebral, a técnica permite resultado semelhantes, quando comparada com os dadores de morte cerebral de critérios expandidos. Discussão: A preservação de órgãos através da oxigenação por membrana extracorporal nos dadores após paragem cardiocirculatória permite resultados funcionais favoráveis e, por esse motivo, poderá contribuir para o aumento do pool de dadores. As dificuldades logísticas associadas à implementação da técnica restringem a sua utilização. Conclusão: A longo prazo, deverão ser criadas condições para a implementação em mais centros da oxigenação por membrana extracorporal nos dadores após paragem cardiocirculatória, aumentando o pool de rins disponíveis para transplante.Associação Portuguesa de Urologia2019-09-21T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.24915/aup.36.1-2.86oai:oai.actaurologicaportuguesa.com:article/86Acta Urológica Portuguesa; Vol. 36 No. 1-2 (2019): January - June; 23-29Acta Urológica Portuguesa; v. 36 n. 1-2 (2019): Janeiro - Junho; 23-292387-04192341-4022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://www.actaurologicaportuguesa.com/index.php/aup/article/view/86https://doi.org/10.24915/aup.36.1-2.86http://www.actaurologicaportuguesa.com/index.php/aup/article/view/86/51Copyright (c) 2019 Portuguese Association of Urologyinfo:eu-repo/semantics/openAccessCorreia, Ana RitaManso, MargaridaRoncon-Albuquerque Jr., RobertoOliveira, GerardoSilva, CarlosCruz, FranciscoAntunes-Lopes, Tiago2022-09-21T09:04:47Zoai:oai.actaurologicaportuguesa.com:article/86Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:55:54.125551Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation Doação de Rins Após Paragem Cardiocirculatória: O Papel da Oxigenação por Membrana Extracorporal |
title |
Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation |
spellingShingle |
Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation Correia, Ana Rita Coronary Circulation Death Donor Selection Extracorporeal Membrane Oxygenation Graft Survival Kidney Transplantation Organ Preservation Circulação Coronária Oxigenação por Membrana Extracorpórea Morte Preservação de Orgão Seleção do Doador Sobrevivência de Enxerto Transplante de Rim |
title_short |
Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation |
title_full |
Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation |
title_fullStr |
Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation |
title_full_unstemmed |
Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation |
title_sort |
Kidney Donation After Cardiocirculatory Death: The Role of Extracorporeal Membrane Oxygenation |
author |
Correia, Ana Rita |
author_facet |
Correia, Ana Rita Manso, Margarida Roncon-Albuquerque Jr., Roberto Oliveira, Gerardo Silva, Carlos Cruz, Francisco Antunes-Lopes, Tiago |
author_role |
author |
author2 |
Manso, Margarida Roncon-Albuquerque Jr., Roberto Oliveira, Gerardo Silva, Carlos Cruz, Francisco Antunes-Lopes, Tiago |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Correia, Ana Rita Manso, Margarida Roncon-Albuquerque Jr., Roberto Oliveira, Gerardo Silva, Carlos Cruz, Francisco Antunes-Lopes, Tiago |
dc.subject.por.fl_str_mv |
Coronary Circulation Death Donor Selection Extracorporeal Membrane Oxygenation Graft Survival Kidney Transplantation Organ Preservation Circulação Coronária Oxigenação por Membrana Extracorpórea Morte Preservação de Orgão Seleção do Doador Sobrevivência de Enxerto Transplante de Rim |
topic |
Coronary Circulation Death Donor Selection Extracorporeal Membrane Oxygenation Graft Survival Kidney Transplantation Organ Preservation Circulação Coronária Oxigenação por Membrana Extracorpórea Morte Preservação de Orgão Seleção do Doador Sobrevivência de Enxerto Transplante de Rim |
description |
Introduction: Chronic kidney disease is a prevalent disorder, with a significant number of late stage patients, which only options are renal replacement therapy and transplantation. Kidney transplantation is associated with higher quality of life and lower mortality. The increasing gap between the demand for kidneys and its availability for transplantation has prompted the research and development of an alternative source to the conventional brain dead donors, the donors after cardiac death. The latter need preservation techniques in order to offer similar functional results. In the present article, we proposed to review the recent evidence about the role of extracorporeal membrane oxygenation as preservation technique in the harvesting of kidneys from donors after circulatory death. Material and Methods: A literature research was conducted in PubMed/MEDLINE, using the following expressions: “kidney transplantation”; “non-heart-beating donor”; “donation after cardiac death”; “extracorporeal membrane oxygenation”; “abdominal normothermic perfusion”. Based on the selected articles, it was performed a non-systematic review, summarizing the recent evidence about the role of extracorporeal membrane oxygenation as preservation technique in the harvesting of kidneys from donors after circulatory death. Results: The evidence suggests that extracorporeal membrane oxygenation is better than the other preservation techniques used in donors after cardiac death, as it has been associated to improved renal allograft outcomes. Regarding the conventional deceased donors, the brain dead, this technique allows similar results, particularly when compared with expanded criteria donors. Discussion: Organ preservation through extracorporeal membrane oxygenation in cardiac death donors has favorable functional results and, for this reason, may contribute to increase the pool of donors. The logistical challenges of the technique restrict its implementation. Conclusion: In the long-term, should be created conditions so that extracorporeal membrane oxygenation in donors after cardiac death may be widely implemented, increasing the number of kidneys obtained for transplantation. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-09-21T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.24915/aup.36.1-2.86 oai:oai.actaurologicaportuguesa.com:article/86 |
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https://doi.org/10.24915/aup.36.1-2.86 |
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oai:oai.actaurologicaportuguesa.com:article/86 |
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http://www.actaurologicaportuguesa.com/index.php/aup/article/view/86 https://doi.org/10.24915/aup.36.1-2.86 http://www.actaurologicaportuguesa.com/index.php/aup/article/view/86/51 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Portuguese Association of Urology info:eu-repo/semantics/openAccess |
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Copyright (c) 2019 Portuguese Association of Urology |
eu_rights_str_mv |
openAccess |
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Associação Portuguesa de Urologia |
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Associação Portuguesa de Urologia |
dc.source.none.fl_str_mv |
Acta Urológica Portuguesa; Vol. 36 No. 1-2 (2019): January - June; 23-29 Acta Urológica Portuguesa; v. 36 n. 1-2 (2019): Janeiro - Junho; 23-29 2387-0419 2341-4022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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