Abstract Journal Transplantation Surgery

Journal Transplantation Surgery TN001 DIAGNOSTIC INFLAMMATORY BIOMARKERS IN ACUTE CHOLANGITIS ANDREI BELYAEV, COLLEEN BERGIN, MICHAEL BOOTH AND DAVID ROWBOTHAM Auckland City Hospital, Auckland, New Zealand Background: The 2018 Tokyo guidelines for acute cholangitis (AC) use white cell count (WCC) as one of the diagnostic criteria. However, the 2018 Tokyo guidelines grading does not provide guidance for AC patients with normal WCC. In this situation, other inflammatory biomarkers also can be used to diagnose AC and grade severity, but their diagnostic values are yet undetermined. The aims of this study were to evaluate the discriminative powers of common inflammatory markers compared with WCC for diagnosing AC and to determine their diagnostic cutoff levels. Methods: This was a retrospective cohort study. Over 2 y, 96 patients who underwent endoscopic biliary decompression were identified from the Auckland City Hospital Radiology Department database. Only patients with a confirmed diagnosis of AC were included in the study. Thirty-four patients with AC and 18 controls met eligibility criteria. Results: Comparing areas under the receiver operating characteristic curves, it was the lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP) that had the highest discriminative powers in diagnosing AC. Values of WCC for diagnosing AC were equal to or above 9.6 × 10/L, neutrophil count equal to or exceeding 4.9 × 10/L, lymphocyte count equal to or below 1.3 × 10/L, NLR 5.3 and above, albumin equal to or below 30.5 g/L, and CRP concentration 23.5 mg/L or above. Conclusions: Lymphocyte count, NLR, and CRP have superior discriminative powers to WCC, albumin, and neutrophil count and can be useful in the diagnosis of AC. TN002 COLD PERFUSION MACHINE ALLOWS PROLONGED STORAGE OF DONOR MATCHED KIDNEYS WITHOUT ADVERSE OUTCOMES SARAH BYRNE, RYAN PEREIRA, IAN ROBERTSON, AI LIN TAN, DAVID LOCKWOOD, VIJAY KANAGARAJAH, MARK RAY, JOHN PRESTON, SIMON WOOD, MALCOLM LAWSON, ANTHONY GRIFFIN AND HANDOO RHEE Princess Alexandra Hospital, QLD Aims: To compare the outcomes of hypothermic perfusion storage and static hypothermic storage of renal transplant allografts at the Princess Alexandra Hospital (PAH) since the procurement of cold perfusion machines (CPM). Methods: All deceased donor renal transplants occurring at the PAH were analyzed from 2011 to 2017. Data reports from the CPM parameters were analyzed. Outcome data was obtained from electronic medical records and statistical analyses were performed. Primary outcome was delayed graft function (DGF). Results: During this period, 1136 renal transplants occurred and the CPM was used on 109 occasions. Of the 109 renal allografts, 66 were donated after brain death (DBD) and 43 were donated after cardiac death (DCD). The mean total storage time was 17.19 +/4.71 hours with a mean cold perfusion time of 10.91 +/4.22 hours. Datasets from the CPM showed that an allograft with reduced flow rates was associated with a dialysis requirement. Cold ischaemic time (CIT) >18hrs was associated with reduced rates of DGF in DCD kidneys placed on the CPM compared with CIT <18 hrs but results did not power statistical significance. There was no difference in the DGF or 1 year serum creatinine for paired kidneys where one was placed on the CPM and one was transplanted immediately. Conclusions: Outcomes of renal transplants placed on the CPM are comparable to static hypothermic storage. There was no difference in DGF or 1 year serum creatinine. CPM datasets may be used to predict outcome such as need for dialysis after transplantation. Increased CIT is not associated with poor clinical outcome. TN003 TRUST TRIAL: TIMING OF REMOVAL FOR URETERIC STENTS POST-RENAL TRANSPLANTATION – EARLY VS STANDARD REMOVAL RYAN CHA, ANNA DARE, WILLIAM HECKER, MOTOHIKO YASITOMO, ANTHONY PHILLIPS, STEPHEN MUNN AND ADAM BARTLETT Auckland City Hospital, Auckland, New Zealand Background: Routine placement of ureteric stent across the anastomosis at the time of transplant reduces the rate of early urological complications. However there is no reported optimal time of ureteric stent removal. Aim: A prospective randomized controlled trial was designed to determine whether early removal (day 4) of ureteric stent is equally effective and safe as late removal (4-6 weeks with cystoscopy) in patients following kidney transplant. Method: From October 2010 and August 2012, 100 adult patients who underwent kidney transplantation at a single centre were randomized equally to control (standard removal) and intervention (early removal) group. In intervention group, the double J ureteric stents were secured to the urinary catheter by Surgeon A or B and removed with the bladder catheter on day 4 post kidney transplant. Control group recipients had their stents removed as an outpatient procedure by flexible cystoscopy at 4-6 weeks post transplant. Results: In total, 50 patients in early removal group and 50 patients in late removal group were analyzed. The baseline Primary outcome of graft survival at 12-month showed no difference in two groups (p = 0.4947).No statistical difference was found in secondary outcomes including patient survival at 12 month, urological complications (leak and obstruction), graft rejection and infection. Conclusion: Early ureteric stent removal at the time of removal of bladder catheter is equally as safe and effective as standard removal of the ureteric stent with flexible cystoscopy at 4-6 weeks post kidney transplant. TN004 UPDATE ON PAEDIATRIC AND NEONATAL ORGAN DONATION