Randomized Trial of Short-Course High-Dose Erythropoietin in Donation after Cardiac Death Kidney Transplant Recipients.
Aydin Z, Mallat MJ, et al.American Journal of Transplantation, 12(7):1793-1800, 2012.
Aims
To explore whether short-term high-dose Epoetin administration could reduce the incidence of delayed graft function (DGF) in donation after cardiac death (DCD) kidney transplant recipients.
Interventions
Intravenous bolus of Epoetin (3.3 × 104 international unit) versus placebo (saline 0.9% solution) on 3 consecutive days, starting 3–4 h before the transplantation and 24 h and 48 h after reperfusion. All patients received an anti-CD25 antibody, steroids, mycophenolate mofetil and delayed introduction of cyclosporine.
Participants
92 DCD kidney transplant recipients.
Outcomes
The primary endpoint was a composite of DGF and primary graft non-function. Secondary endpoints included the duration of DGF, the incidence of biopsy-confirmed acute rejection, endogenous creatinine clearances, and patient and kidney graft survival at 1-year post transplantation. The safety assessment included incidence of hypertension and any arterial or venous thrombosis.
Follow-up
1 year
CET Conclusions
In this good quality double blinded trial the infusion of high dose erythropoietin (epoetin) in comparison with a placebo did not produce any change in the incidence of primary non function and delayed graft function in recipients of DCD kidneys. However patients who received epoetin did show a significant increase in thrombotic events at one month and one year after transplantation.
Data analysis
Strict intention-to-treat analysis
Trial registration
NCT00157300 (ClinicalTrials.gov)