Kidney transplantation from uncontrolled Donation after Cardiac Death (DCD) has been re-introduced into clinical practice in France since June 2006. In addition to being the mandatory in situ organ preservation technique for DCD liver harvesting, sub diaphragmatic ECMO is considered by many teams as superior to double-balloon triple-lumen (DBTL; Gillots) catheter for kidney graft outcome. The former technique has gradually replaced the latter in our institution since January 2010.
We conducted a single-center retrospective observational study to compare recipients outcome between the two donors preservation techniques.
Between 1st of January 2007 and 30th September 2012, 88 patients received a kidney graft from DCD in our institution; of which 56 (64%) were preserved with DBTL and 32 (36%) with ECMO. The two preservation technique groups were comparable in terms of: donors demographic characteristics (Age, sex ratio, weight, height), recipients demographics and waiting time on transplant list, HLA mismatch levels, no-flow times and warm-ischemia times.
There were 4 cases (12.5%) of primary graft non-function in DBTL vs. 7 cases (21.9%) in ECMO group. Of the remaining kidneys, 50 (96%) and 21 (84%) experienced delayed-graft function in DBTL and ECMO groups, respectively. Recipients had the same renal function at 3 months after transplantation (GFR estimated by MDRD: 41.5+/-15.4 ml/min/1.73m2 vs. 43.8+/-19.3 ml/min/1.73m2, in DBTL and ECMO, respectively).
Although ECMO preservation technique holds promise to ameliorate functional results of DCD kidney transplantation, one must be very careful in the implementation phase of this technique, because of the learning curve.
To cite this abstract in AMA style:Abboud I, Viglietti D, Gaudez F, Fieux F, Roussin F, Antoine C, Glotz D. Learning Curve of ECMO in DCD (Better the Devil You Know?) [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/learning-curve-of-ecmo-in-dcd-better-the-devil-you-know/. Accessed February 21, 2018.
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