The evolution of donation after circulatory death renal transplantation: a decade of experience

Global trends of delayed graft function in kidney transplantation from 2013 to 2023: a bibliometric analysis

Delayed graft function (DGF) is an early complication after kidney transplantation. The literature on DGF has experienced substantial growth. However, there is a lack of bibliometric analysis of DGF. This study aimed to analyze the scientific outputs of DGF and explore its hotspots from 2013 to 2023 by using CiteSpace and VOSviewer. The 2058 pieces of literature collected in the Web of Science Core Collection (WOSCC) from 1 January 2013 to 31 December 2023 were visually analyzed in terms of the annual number of publications, authors, countries, journals, literature co-citations, and keyword clustering by using CiteSpace and VOSviewer. We found that the number of papers published in the past ten years showed a trend of first increasing and then decreasing; 2021 was the year with the most posts. The largest number of papers was published by the University of California System, and the largest number of papers was published by the United States. The top five keyword frequency rankings are: 'delayed graft function', 'kidney transplantation', 'renal transplantation', 'survival', and 'recipients'. These emerging trends include 'brain death donors', 'blood absence re-injection injuries', 'tacrolimus', 'older donors and recipients', and 'artificial intelligence and DGF'. In summary, this study reveals the authors and institutions that could be cooperated with and discusses the research hotspots in the past ten years. It provides a reference and direction for future research and application of DGF.

Incidencia de infecciones en el postrasplante renal inmediato

Introducción: El receptor de un trasplante renal es un paciente de alto riesgo para sufrir infección debido a las potenciales complicaciones quirúrgicas y al tratamiento inmunosupresor que reciben.El desarrollo de infecciones supone un riesgo aumentado de pérdida del injerto y de la mortalidad. Objetivos: El objetivo principal fue conocer la incidencia de las infecciones más frecuentes en el paciente con un trasplante renal, durante el periodo postrasplante inmediato.Los objetivos secundarios fueron describir los gérmenes responsables de las infecciones más frecuentes y analizar la relación entre los tipos de infección estudiados y sus posibles factores de riesgo. Metodología: Estudio observacional retrospectivo en pacientes trasplantados renales entre enero de 2018 y diciembre de 2019 durante el periodo del postrasplante inmediato.Resultados: La incidencia de infección fue 69,4%, los síndromes descritos fueron infección del tracto urinario (48%), bacteriemia (9,2%), infección relacionada con catéter (8,2%) e infección por citomegalovirus (4,1%). Los microorganimos más frecuentemente implicados, en estos procesos infecciosos fueron Escherichia coli (16,3%), Enterococus faecium (12,2%) y Enterobacter cloacae (8,1%).Se ha encontrado relación significativa entre la aparición de infección y la duración del ingreso, así como con la presencia o no del antecedente personal de hipertensión arterial. También entre la incidencia de infección relacionada con el catéter venoso central y el tiempo que permaneció insertado. Conclusiones: La infección más frecuente encontrada en el postrasplante renal inmediato fue la infección del tracto urinario, mientras que el microorganismo más presente habitualmente en los procesos infecciosos fue la Escherichia coli.

Analysis of risk factors for donation after circulatory death kidney transplantation in Japan

Background

In Japan, donations after circulatory death kidney transplantation are widely performed due to legislation delays. The number of donations after brain death kidney transplantations is increasing, but the target remains unmet. We reviewed the outcomes of donation after circulatory death in Japan.

Methods

We analyzed 2923 deceased kidney transplantations (2239: donation after circulatory death (DCD), 684: donation after brain death (DBD)) performed in Japan from 2000 to 2019. The outcomes of the DCD and DBD groups were compared. We examined the risk factors for graft loss in the DCD group.

Results

The 5-year patient survival and death-censored graft survival rates of the DCD group, obtained by propensity score matching, were 93.6% and 95.2%, respectively, which were equivalent to 94.2% and 93.8%, respectively, obtained in the DBD group. Older donors (≥ 50 years) and prolonged cold ischemia time (≥ 12 h) were risk factors for graft loss; in the presence of these, graft survival was lower in the DCD group.

Conclusions

Older donors and prolonged cold ischemia time reduced graft survival in the DCD group. Proper evaluation of donors and careful preparation for transplant surgery are, therefore, essential to ensure good transplant outcomes.

Singapore Advanced Cardiac Life Support Guidelines 2021

Advanced cardiac life support (ACLS) emphasises the use of advanced airway management and ventilation, circulatory support and the appropriate use of drugs in resuscitation, as well as the identification of reversible causes of cardiac arrest. Extracorporeal cardiopulmonary resuscitation and organ donation, as well as special circumstances including drowning, pulmonary embolism and pregnancy are addressed. Resuscitation does not end with ACLS but must continue in post-resuscitation care. ACLS also covers the recognition and management of unstable pre-arrest tachy- and bradydysrhythmias that may deteriorate further.