Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Prevention of Delayed Graft Function in Kidney Transplant Recipients by Continuous Infusion of Prostaglandin-Analogue Iloprost: A Single-Center Prospective Study

Massimiliano Veroux*
* ORCID logo ,
Floriana Sanfilippo
,
Giuseppe Roscitano
,
Martina Maria Giambra
,
Alessia Giaquinta
,
Giordana Riccioli
,
Domenico Zerbo
,
Daniela Corona
,
Massimiliano Sorbello
ORCID logo ,
Pierfrancesco Veroux
Version 1 : Received: 15 December 2023 / Approved: 18 December 2023 / Online: 18 December 2023 (06:07:16 CET)

A peer-reviewed article of this Preprint also exists.

Veroux, M.; Sanfilippo, F.; Roscitano, G.; Giambra, M.; Giaquinta, A.; Riccioli, G.; Zerbo, D.; Corona, D.; Sorbello, M.; Veroux, P. Prevention of Delayed Graft Function in Kidney Transplant Recipients through a Continuous Infusion of the Prostaglandin Analogue Iloprost: A Single-Center Prospective Study. Biomedicines 2024, 12, 290. Veroux, M.; Sanfilippo, F.; Roscitano, G.; Giambra, M.; Giaquinta, A.; Riccioli, G.; Zerbo, D.; Corona, D.; Sorbello, M.; Veroux, P. Prevention of Delayed Graft Function in Kidney Transplant Recipients through a Continuous Infusion of the Prostaglandin Analogue Iloprost: A Single-Center Prospective Study. Biomedicines 2024, 12, 290.

Abstract

Background: Delayed graft function (DGF) is common after kidney transplantation from de-ceased donor and may significantly affect post-transplant outcomes. This study aimed to evaluating whether an innovative approach, based on the administration of intravenous prostaglandin-analogue iloprost, could be beneficial in reducing the incidence of DGF occurring after kidney transplantation from deceased donors. Methods: This prospective, randomised (1:1), place-bo-controlled study enrolled all consecutive patients who received a kidney transplantation from a deceased donor from January 2000 to December 2012 and who were treated in the peri-transplant period with the prostaglandin-analogue iloprost at 0.27 μg/min through elastomeric pump (treatment group) or placebo (control group). Results: A total of 476 patients were included : DGF was reported in 172 (36.1%) patients in the entire cohort. The multivariate analysis showed that donor’s age > 70 years (OR 2.50, 95% Confidence Interval (CI) 1.40-3.05, p < .001), cold ischemia time > 24 h (OR 2.60, 95 CI 1.50-4.51, p < .001), donor’s AKI (OR 2.71, 95% CI 1.61-4.52, p = .021) and, above all, recipient’s arterial hypotension (OR 5.06, 95% CI 2.52-10.1, p < .0001) were the strongest risk factors for developing post-transplant DGF. The incidence of DGF was 21.4% in the treatment group and 50.9% in the control group (p< .001). Interestingly, among patients who developed DGF, those who received iloprost had a shorter duration of post-transplant DGF (10.58.3 v s13.46.7, days, p= .016). Conclusions: This study showed that the use of a continuous infusion of iloprost could safely and effectively reduce the incidence of DGF in recipients of deceased donor kidneys, allowing a better graft functionality as well as a better graft survival.

Keywords

Kidney transplantation; Marginal Donor; Cold Ischemia Time; Donor Age; Acute kidney Injury; Deceased Donor; Graft Survival; Patient Survival

Subject

Medicine and Pharmacology, Transplantation

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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