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On-line Access: 2024-08-27
Received: 2023-10-17
Revision Accepted: 2024-05-08
Crosschecked: 2023-07-21
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Yamei CHENG, Luying GUO, Xue REN, Zhenzhen YANG, Junhao LV, Huiping WANG, Wenhan PENG, Hongfeng HUANG, Jianyong WU, Jianghua CHEN, Rending WANG. Outcomes of allograft from donor kidney microthrombi and secondary recipient thrombotic microangiopathy: should we consider loosening the belt?[J]. Journal of Zhejiang University Science B, 2023, 24(6): 524-529.
@article{title="Outcomes of allograft from donor kidney microthrombi and secondary recipient thrombotic microangiopathy: should we consider loosening the belt?",
author="Yamei CHENG, Luying GUO, Xue REN, Zhenzhen YANG, Junhao LV, Huiping WANG, Wenhan PENG, Hongfeng HUANG, Jianyong WU, Jianghua CHEN, Rending WANG",
journal="Journal of Zhejiang University Science B",
volume="24",
number="6",
pages="524-529",
year="2023",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2200451"
}
%0 Journal Article
%T Outcomes of allograft from donor kidney microthrombi and secondary recipient thrombotic microangiopathy: should we consider loosening the belt?
%A Yamei CHENG
%A Luying GUO
%A Xue REN
%A Zhenzhen YANG
%A Junhao LV
%A Huiping WANG
%A Wenhan PENG
%A Hongfeng HUANG
%A Jianyong WU
%A Jianghua CHEN
%A Rending WANG
%J Journal of Zhejiang University SCIENCE B
%V 24
%N 6
%P 524-529
%@ 1673-1581
%D 2023
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2200451
TY - JOUR
T1 - Outcomes of allograft from donor kidney microthrombi and secondary recipient thrombotic microangiopathy: should we consider loosening the belt?
A1 - Yamei CHENG
A1 - Luying GUO
A1 - Xue REN
A1 - Zhenzhen YANG
A1 - Junhao LV
A1 - Huiping WANG
A1 - Wenhan PENG
A1 - Hongfeng HUANG
A1 - Jianyong WU
A1 - Jianghua CHEN
A1 - Rending WANG
J0 - Journal of Zhejiang University Science B
VL - 24
IS - 6
SP - 524
EP - 529
%@ 1673-1581
Y1 - 2023
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B2200451
Abstract: There is currently a huge worldwide demand for donor kidneys for organ transplantation. Consequently, numerous marginal donor kidneys, such as kidneys with microthrombi, are used to save patients’ lives. While some studies have shown an association between the presence of microthrombi in donor kidneys and an increased risk for delayed graft function (DGF) (McCall et al., 2003; Gao et al., 2019), other studies have demonstrated that microthrombi negatively impact the rate of DGF (Batra et al., 2016; Hansen et al., 2018), but not graft survival rate (McCall et al., 2003; Batra et al., 2016; Gao et al., 2019). In contrast, Hansen et al. (2018) concluded that fibrin thrombi were not only associated with reduced graft function six months post-transplantation but also with increased graft loss within the first year of transplantation. On the other hand, Batra et al. (2016) found no significant differences in the DGF rate or one-year graft function between recipients in diffuse and focal microthrombi groups. To date, however, the overall influence of donor kidney microthrombi and the degree of influence on prognosis remain controversial, necessitating further research.
[1]ÁvilaA, GavelaE, SanchoA, 2021. Thrombotic microangiopathy after kidney transplantation: an underdiagnosed and potentially reversible entity. Front Med, 8:642864.
[2]BatraRK, HeilmanRL, SmithML, et al., 2016. Rapid resolution of donor-derived glomerular fibrin thrombi after deceased donor kidney transplantation. Am J Transplant, 16(3):1015-1020.
[3]GaoGF, ChenLX, BrownIE, et al., 2019. Donor characteristics, recipient outcomes, and histologic findings of kidney allografts with diffuse donor-derived glomerular fibrin thrombi. Transplantation, 103(9):1921-1927.
[4]GarrousteC, BaudenonJ, GataultP, et al., 2019. No impact of disseminated intravascular coagulation in kidney donors on long-term kidney transplantation outcome: a multicenter propensity-matched study. Am J Transplant, 19(2):448-456.
[5]HansenD, RørvigS, AndersenCB, et al., 2018. Fibrin thrombi in deceased donor kidneys: prevalence and influence on graft function and graft survival in transplanted patients. APMIS, 126(1):3-8.
[6]KarthikeyanV, ParasuramanR, ShahV, et al., 2003. Outcome of plasma exchange therapy in thrombotic microangiopathy after renal transplantation. Am J Transplant, 3(10):1289-1294.
[7]McCallSJ, Tuttle-NewhallJE, HowellDN, et al., 2003. Prognostic significance of microvascular thrombosis in donor kidney allograft biopsies. Transplantation, 75(11):1847-1852.
[8]NghiemDD, OlsonPR, SureshkumarKK, 2009. Role of pulsatile perfusion with tissue plasminogen activator in deceased donor kidneys with extensive glomerular thrombosis. Transplant Proc, 41(1):29-31.
[9]PasturalM, BarrouB, DelcourtA, et al., 2001. Successful kidney transplantation using organs from a donor with disseminated intravascular coagulation and impaired renal function: case report and review of the literature. Nephrol Dial Transplant, 16(2):412-415.
[10]RevolloJY, CuffyMC, WitteDP, et al., 2015. Case report: hemolytic anemia following deceased donor renal transplantation associated with tranexamic acid administration for disseminated intravascular coagulation. Transplant Proc, 47(7):2239-2242.
[11]SibuleskyL, GohhR, CharpentierK, et al., 2013. Kidney transplantation from donors with severe disseminated intravascular coagulation. ISRN Transplant, 2013:646310.
[12]SoaresKC, ArendLJ, LonzeBE, et al., 2017. Successful renal transplantation of deceased donor kidneys with 100% glomerular fibrin thrombi and acute renal failure due to disseminated intravascular coagulation. Transplantation, 101(6):1134-1138.
[13]WangCJ, ShafiqueS, MccullaghJ, et al., 2011. Implications of donor disseminated intravascular coagulation on kidney allograft recipients. Clin J Am Soc Nephrol, 6(5):1160-1167.
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