Abstract: FR-PO1043

Effect of Spontaneous Donor Hypothermia on Graft Outcome in Organ Transplantation

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Krämer, Bernhard K., University Hospital Mannheim, Mannheim, Germany
  • Benck, Urs, University Medicine Mannheim, Mannheim, Germany
  • Schnuelle, Peter, University Medicine Mannheim, Mannheim, Germany

Group or Team Name

  • Randomized Dopamine Trial Study Group
Background

A previous controlled donor intervention trial found that therapeutic hypothermia reduced delayed graft function (DGF) after kidney transplantation.

Methods

This retrospective cohort study nested in the randomized dopamine trial (ClinicalTrials.gov identifier: NCT000115115) investigates the effects of spontaneous donor hypothermia on initial kidney graft function, and evaluates graft survival including heart and liver transplants.All 264 donors who met the eligibility criteria for enrollment in the randomized dopamine trial were grouped by occurrence of spontaneous hypothermia. Hypothermia was defined by a core body temperature of less than 36.0°C before organ procurement. Accordingly, we assigned 54 donors to the hypothermia group and the remaining 210 donors served as controls.

Results

Hypothermia was associated with less DGF after kidney transplantation (OR 0.56, 95%CI 0.34 – 0.91). The benefit was greater when need for more than a single post-transplant dialysis session was analyzed (OR 0.48, 95%CI 0.28 – 0.82). Donor dopamine ameliorated dialysis requirement independently from hypothermia in a time-relationship with exposure (OR 0.93; 95%CI 0.87 – 0.98, per hour). Hypothermia did not alter kidney graft survival (HR 0.83, 95%CI 0.54 – 1.27), while dopamine treatment was associated with improved long-term outcome (HR 0.95, 95%CI 0.91 – 0.99 per hour). Stratified analyses of non-renal organs in tertiles of the donor’s core body temperature disclosed negative effects on heart allograft survival (HR 1.89, 95%CI 1.09 – 3.27).

Conclusion

Spontaneous donor hypothermia is associated with less DGF but does not appear to affect long-term outcome of the kidney graft. Our data raise safety concerns against therapeutic hypothermia in multi-organ donors when a thoracic transplantation is considered.