|
1
|
Dubourg Q, Savoye E, Drouin S, Legeai C, Barrou B, Rondeau E, Buob D, Kerbaul F, Bronchard R, Galichon P. Effect of Cardiac Arrest in Brain-dead Donors on Kidney Graft Function. Transplantation 2024; 108:768-776. [PMID: 37819189 DOI: 10.1097/tp.0000000000004825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
BACKGROUND Cardiac arrest (CA) causes renal ischemia in one-third of brain-dead kidney donors before procurement. We hypothesized that the graft function depends on the time interval between CA and organ procurement. METHODS We conducted a retrospective population-based study on a prospectively curated database. We included 1469 kidney transplantations from donors with a history of resuscitated CA in 2015-2017 in France. CA was the cause of death (primary CA) or an intercurrent event (secondary CA). The main outcome was the percentage of delayed graft function, defined by the use of renal replacement therapy within the first week posttransplantation. RESULTS Delayed graft function occurred in 31.7% of kidney transplantations and was associated with donor function, vasopressors, cardiovascular history, donor and recipient age, body mass index, cold ischemia time, and time to procurement after primary cardiac arrest. Short cold ischemia time, perfusion device use, and the absence of cardiovascular comorbidities were protected by multivariate analysis, whereas time <3 d from primary CA to procurement was associated with delayed graft function (odds ratio 1.38). CONCLUSIONS This is the first description of time to procurement after a primary CA as a risk factor for delayed graft function. Delaying procurement after CA should be evaluated in interventional studies.
Collapse
Affiliation(s)
- Quentin Dubourg
- Kidney Transplantation, APHP Sorbonne University, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emilie Savoye
- Agence de la biomédecine, Direction Prélèvement Greffe Organes-Tissus, Saint-Denis La Plaine, France
| | - Sarah Drouin
- Kidney Transplantation, APHP Sorbonne University, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
- Common and Rare Kidney Diseases (CoRaKID) Unit, Institut National de la Santé and de la Recherche Médicale (INSERM) U1155, Paris, France
| | - Camille Legeai
- Agence de la biomédecine, Direction Prélèvement Greffe Organes-Tissus, Saint-Denis La Plaine, France
| | - Benoit Barrou
- Kidney Transplantation, APHP Sorbonne University, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Rondeau
- Kidney Transplantation, APHP Sorbonne University, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
- Common and Rare Kidney Diseases (CoRaKID) Unit, Institut National de la Santé and de la Recherche Médicale (INSERM) U1155, Paris, France
| | - David Buob
- Common and Rare Kidney Diseases (CoRaKID) Unit, Institut National de la Santé and de la Recherche Médicale (INSERM) U1155, Paris, France
- Department of Pathology, APHP Sorbonne University, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Francois Kerbaul
- Agence de la biomédecine, Direction Prélèvement Greffe Organes-Tissus, Saint-Denis La Plaine, France
| | - Régis Bronchard
- Agence de la biomédecine, Direction Prélèvement Greffe Organes-Tissus, Saint-Denis La Plaine, France
| | - Pierre Galichon
- Kidney Transplantation, APHP Sorbonne University, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
- Common and Rare Kidney Diseases (CoRaKID) Unit, Institut National de la Santé and de la Recherche Médicale (INSERM) U1155, Paris, France
| |
Collapse
|
|
2
|
Perman SM, Elmer J, Maciel CB, Uzendu A, May T, Mumma BE, Bartos JA, Rodriguez AJ, Kurz MC, Panchal AR, Rittenberger JC. 2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2024; 149:e254-e273. [PMID: 38108133 DOI: 10.1161/cir.0000000000001194] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Cardiac arrest is common and deadly, affecting up to 700 000 people in the United States annually. Advanced cardiac life support measures are commonly used to improve outcomes. This "2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support" summarizes the most recent published evidence for and recommendations on the use of medications, temperature management, percutaneous coronary angiography, extracorporeal cardiopulmonary resuscitation, and seizure management in this population. We discuss the lack of data in recent cardiac arrest literature that limits our ability to evaluate diversity, equity, and inclusion in this population. Last, we consider how the cardiac arrest population may make up an important pool of organ donors for those awaiting organ transplantation.
Collapse
|