Effect of machine perfusion preservation on delayed graft function in non-heart-beating donor kidneys – early results |
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Authors: | J H C Daemen B de Vries A P A Oomen J DeMeester G Kootstra |
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Institution: | (1) Department of Surgery, University Hospital, P.O. Box 5800, NL-6202 AZ Maastricht, The Netherlands, NL;(2) Eurotransplant Foundation, P.O. Box 2304 NL-2301 CH Leiden, The Netherlands, NL |
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Abstract: | The functioning of non-heart-beating (NHB) donor kidneys upon transplantation is often delayed. To evaluate the effect of
preservation by machine perfusion (MP) on early post-transplant function, 37 NHB donor kidneys were compared to 74 matched
heart-beating (HB) donor kidneys preserved by cold storage (CS). The NHB donor kidneys were subject to 49 ± 34 min of warm
ischemia. Delayed function (DF) and primary nonfunction (PNF) rates were significantly higher for NHB than for HB donor kidneys
(49 % and 19 % vs 34 % and 7 %, respectively). Consequently, renal function was impaired but recovered within 6 months. MP
could not eliminate the differences in DF rate between NHB and HB donor kidneys. However, NHB donor kidneys preserved by MP
showed less DF than that reported in kidneys preserved by CS. This suggests that MP has a beneficial effect on ischemically
damaged kidneys. The similar results observed with category 2 and category 3 NHB donors also suggest this effect. The high
PNF rate emphasizes the need for viability tests that prevent the transplantation of nonviable organs. We conclude that MP
alone is not sufficient to reduce DF and PNF rates in NHB donor kidneys.
Received: 16 January 1997 Received after revision: 7 April 1997 Accepted: 11 April 1997 |
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Keywords: | Non-heart-beating donor machine perfusion Machine perfusion non-heart-beating donor Kidney transplantation non-heart-beating donor |
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