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Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death |
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| Authors: | Jürgen Treckmann Cyril Moers Jacqueline M. Smits Anja Gallinat Mark‐Hugo J. Maathuis Margitta van Kasterop‐Kutz Ina Jochmans Jaap J. Homan van der Heide Jean‐Paul Squifflet Ernest van Heurn Günter R. Kirste Axel Rahmel Henri G. D. Leuvenink Jacques Pirenne Rutger J. Ploeg Andreas Paul |
| Affiliation: | 1. Clinic for General, Visceral and Transplantation Surgery, University Hospital Essen, Germany;2. Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands;3. Eurotransplant International Foundation, Leiden, The Netherlands;4. Department of Abdominal Transplant Surgery – Transplant Coordination, University Hospital Leuven, Belgium;5. Department of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands;6. Department of Abdominal Surgery and Transplantation, CHU Sart Tilman, University of Liège, Belgium;7. Department of Surgery, University Hospital Maastricht, The Netherlands;8. Deutsche Stiftung Organtransplantation, Frankfurt, Germany |
| Abstract: | The purpose of this study was to analyze the possible effects of machine perfusion (MP) versus cold storage (CS) on delayed graft function (DGF) and early graft survival in expanded criteria donor kidneys (ECD). As part of the previously reported international randomized controlled trial 91 consecutive heart‐beating deceased ECDs – defined according to the United Network of Organ Sharing definition – were included in the study. From each donor one kidney was randomized to MP and the contralateral kidney to CS. All recipients were followed for 1 year. The primary endpoint was DGF. Secondary endpoints included primary nonfunction and graft survival. DGF occurred in 27 patients in the CS group (29.7%) and in 20 patients in the MP group (22%). Using the logistic regression model MP significantly reduced the risk of DGF compared with CS (OR 0.460, P = 0.047). The incidence of nonfunction in the CS group (12%) was four times higher than in the MP group (3%) (P = 0.04). One‐year graft survival was significantly higher in machine perfused kidneys compared with cold stored kidneys (92.3% vs. 80.2%, P = 0.02). In the present study, MP preservation clearly reduced the risk of DGF and improved 1‐year graft survival and function in ECD kidneys. (Current Controlled Trials number: ISRCTN83876362). |
| Keywords: | donation expanded donor pool kidney organ preservation and procurement outcome |