Normothermic and Hypothermic Oxygenated Perfusion for Donation After Circulatory Death in Kidney Transplantation: Do We Pay Higher Risk of Severe Infection After Transplantation?: a Case Report

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2020 Feb 12

PMID 32041547

Citations 3

Authors

Matteo Ravaioli

Valeria Corradetti

Matteo Renzulli

Giuliana Germinario

Lorenzo Maroni

Federica Odaldi

Guido Fallani

Anna Paola Pezzuto

Daniele Parlanti

Raffaele Bova

Claudia Bini

Gaetano La Manna

Giorgia Comai

Affiliations

Soon will be listed here.

Abstract

Background: Normothermic and hypothermic oxygenated perfusion for donation after circulatory death in kidney transplantation are becoming popular in Italy, with the purpose of reducing the risk of primary non function and delayed graft function due to the prolonged warm ischemia time. Potential complications related to these procedures are currently under investigation and are continuously emerging with the increasing experience. Post-operative infections - in particular graft arteritis - are a rare complication but determine high risk of mortality and of graft loss. The acute onset of the arterial complications makes it very difficult to find an effective treatment, and early diagnosis is crucial for saving both patient and graft. Prevention of such infections in this particular setting are advisable.

Case Presentation: We present a patient with an acute arterial rupture after transplantation of a DCD graft treated in-vivo hypothermic oxygenated perfusion. The cause was a severe arteritis of the renal artery caused by Candida krusei and Pseudomonas aeruginosa. We discussed our treatment and we compared it to the other reported series.

Conclusion: Fungal infections in DCD transplant may be treacherous and strategies to prevent them should be advocated.

Citing Articles

Assessing the impact of positive cultures in preservation fluid on renal transplant outcomes: a scoping review.

Machado F, Vicari A, Bauer A J Nephrol. 2024; .

PMID: 38869823 DOI: 10.1007/s40620-024-01972-1.

The impact of preservation fluid culture on graft site arteritis: A systematic review and meta-analysis.

Rinaldi M, Bonazzetti C, Gatti M, Caroccia N, Comai G, Ravaioli M Transpl Infect Dis. 2022; 24(6):e13979.

PMID: 36271646 PMC: 10078333. DOI: 10.1111/tid.13979.

Extracellular Vesicles Derived from Mesenchymal Stromal Cells Delivered during Hypothermic Oxygenated Machine Perfusion Repair Ischemic/Reperfusion Damage of Kidneys from Extended Criteria Donors.

Rampino T, Gregorini M, Germinario G, Pattonieri E, Erasmi F, Grignano M Biology (Basel). 2022; 11(3).

PMID: 35336724 PMC: 8945029. DOI: 10.3390/biology11030350.

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