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Outcomes of DCD kidneys recovered for transplantation with versus without pre‐mortem heparin administration
Author(s) -
Narvaez J. Reinier F.,
Noyes Katia,
Nie Jing,
Kayler Liise K.
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13624
Subject(s) - medicine , heparin , transplantation , administration (probate law) , surgery , anesthesia , political science , law
Background Pre‐mortem heparin administration during donation after circulatory death (DCD) organ recovery may be particularly important to improve perfusion and prevent graft thrombosis. However, pre‐mortem heparin administration is not universally practiced in the US and scarce data exist regarding its efficacy. Methods Using a national transplant registry data, we identified DCD kidneys recovered for transplantation from January 1, 2003, to March 10, 2017, and examined discard and outcomes after transplantation using bivariate and multivariable analyses. Organs with unknown or missing donor heparin status (n = 193), seropositive HIV (n = 10), HTLV (n = 33), hepatitis B (n = 26), or hepatitis C (n = 648) were excluded. Results Of 24 861 DCD kidneys recovered with (n = 22 557) or without pre‐mortem heparin administration (n = 2304), discard occurred in 19.1% and 20.8%, respectively ( P = 0.05). On multivariate analysis, heparin use was not associated with discard (aOR 1.02, 95% CI 0.89‐1.17, P = 0.820). Overall graft survival of no‐heparin (n = 1791) vs heparin groups (n = 17 968) was similar on univariate and multivariate analysis (aHR 0.98, 95% CI 0.87‐1.09, P = 0.640 ).Conclusion DCD kidneys from donors that have not received pre‐mortem heparin administration have acceptable transplant outcomes and are not associated with discard.