Cold pulsatile machine perfusion versus static cold storage in kidney transplantation: a single centre experience
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction. We present our experience with hypothermic machine perfusion (HMP) versus cold storage (CS) in relation to kidney transplant outcomes. Methods. Retrospective analysis of 33 consecutive HMP kidney transplant outcomes matched with those of 33 cold stored: delayed graft function (DGF), length of hospital stay (LOS), estimated glomerular filtration rate (eGFR), and patient and graft survival were compared. Renal Resistive Indexes (RIs) during HMP in relation to DGF were also analysed. Results. In the HMP group, mean HMP time was 5.7 ± 3.9 hours with a mean cold ischaemic time (CIT) of 15 ± 5.6 versus 15.1 ± 5.3 hours in the CS group. DGF was lower in the HMP group (p=0.041), and donation after Circulatory Death (DCD) was a predictor for DGF (p<0.01). HMP decreased DGF in DCD grafts (p=0.036). Patient and graft survival were similar, but eGFR at 365 days was higher in the HMP cohort (p<0.001). RIs decreased during HMP (p<0.01); 2-hours RI ≥ 0.45 mmHg/mL/min predicted DGF in DCD kidneys (75% sensitivity, 80% specificity; area under the curve 0.78); 2-hours RI ≥ 0.2 mmHg/ml/min predicted DGF in DBD grafts (sensitivity 100%, specificity 91%; area under the curve 0.87). Conclusion. HMP decreased DGF compared to CS, offering viability assessment pretransplant and improving one-year renal function of the grafts.
Date Issued
2019-02-08
Date Acceptance
2019-01-08
Citation
BioMed Research International, 2019, 2019
ISSN
2314-6133
Publisher
Hindawi Publishing Corporation
Journal / Book Title
BioMed Research International
Volume
2019
Copyright Statement
© 2019 Maria Irene Bellini et al. 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.
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Sponsor
Roche Organ Transplant Research Foundation
Grant Number
n/a
Subjects
Science & Technology
Life Sciences & Biomedicine
Biotechnology & Applied Microbiology
Medicine, Research & Experimental
Research & Experimental Medicine
DELAYED GRAFT FUNCTION
RENAL RESISTANCE
RISK-FACTORS
Publication Status
Published
Article Number
ARTN 7435248
Date Publish Online
2019-01-16