Donor Desmopressin Is Associated With Superior Graft Survival After Kidney Transplantation.
Benck U, Gottmann U, et al.Transplantation 92(11): 1252-1258, 2011.
Aims
To determine whether donor exposure to desmopressin, 1-deamino-8-D-arginine-vasopressin (DDAVP) before organ retrieval would improve renal transplant outcomes.
Interventions
DDAVP exposure versus no DDAVP.
Participants
487 renal transplant recipients who received a kidney graft from 264 brain-dead donors.
Outcomes
Uncensored graft survival, death-censored graft survival at 1 and 2 years, delayed graft function, biopsy-proven acute rejections and cold ischemic time.
Follow-up
2 years
CET Conclusions
In this posthoc analysis the use of desmopressin in the donor appears to be associated with improved renal allograft survival in those patients where the cold ischemia time was less than 14 hours. The use of desmopressin was analysed as a dichotomous variable but the validity of the study is somewhat limited by the design, as the cohort was extracted from the trial of dopamine treatment of brain dead donors before retrieval of kidneys.
Data analysis
Per protocol analysis
Quality notes
This is a retrospective analysis of a previous publication of the same RCT: Schnuelle P, Gottmann U, Hoeger S, et al. Effects of donor pretreatment with dopamine on graft function after kidney transplantation: a randomized controlled trial. JAMA 2009;302:1067–75. The methodological quality assessment was based on the previous publication.
Trial registration
NCT00115115 (ClinicalTrials.gov)