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PERFUSION AND PRESERVATION OF ABDOMIAL ORGANS

CARDIOPLEGIA AND HEART TRANSPLANTATION

custodiol

CUSTODIOL
Kidney transplantation

  • No colloids: starch is nephrotoxic and promotes microvascular obstructions
  • Protection of the kidney proximal tubules: ketoglutarate prevents mitochondrial energetic deficiency
  • Equal to UW and better than Eurocollins: proven by a European study including 47 centres, over 1000 kidneys, even at CIT’s > 35 hrs
  • Protection against cold-to-normothermic ischemia: CUSTODIOL has been reported to be useful for kidney tumour resection as well as for the protection against long-lasting cold-to-normothermic ischemia of kidneys during thoraco-abdominal aortic aneurysm (TAAA) repair
  • Rapid postoperative recovery: large clinical trials show reduced necessity to dialyse

CUSTODIOL performs as well as UW, and significantly better than Eurocollins for kidney transplantation1)

UW-HTK study EC-HTK study
EC-HTK study HTK (n=314) UW (n=297) HTK (n=292) EC (n=277)
1 year 83% 81% 80% 78%
2 year 77% 73% 76% 71%
3 year 73% 68% 70% 68%
INF 33% 33% 29% 43%

n = number of transplants

INF = Initial non-function was defined as the absence of life-sustaining renal function, requiring dialysis treatment on two or more occasions, during the first week after transplantation. 

1) de Boer J, De Meester J, Smits JM, Groenewoud AF, Bok A, van der Velde O, Doxiadis II, Persijn GG. Eurotransplant randomized multicenter kidney graft preservation study comparing HTK with UW and Euro-Collins. Transpl Int. 1999;12(6):447-53


CUSTODIOL provides protection against renal ischemic injury in patients undergoing thoracoabdominal aortic aneurysm (TAAA) open repair2)

Acute kidney injury CUSTODIOL (n=42) Ringer’s group (n=42)
No AKI 38.1% 9.5%
AKI type 1 35.7% 50%
AKI type 2 9.5% 21.4%
AKI type 3 16.7% 19.0%

Acute kidney injury (AKI) was defined by Kidney Disease Improving Global Outcomes guidelines discharge. Freedom from AKI was significantly increased in the CUSTODIOL group vs the group treated with cold lactated Ringer’s solution despite longer total renal ischemic time (51.5 minutes vs 43.6 minutes). Furthermore, CUSTODIOL does not require any implementation of the solution with osmotic agents and prednisolone. 

2) Tshomba Y, Kahlberg A, Melissano G, Coppi G, Marone E, Ferrari D, Lembo R, Chiesa R. Comparison of renal perfusion solutions during thoracoabdominal aortic aneurysm repair. J Vasc Surg. 2014 Mar;59(3):623-33