Hypothermic Machine Perfusion as a National Standard Preservation Method for Deceased Donor Kidneys

Aukje Brat; Kirsten M de Vries; Ernst W E van Heurn; Volkert A L Huurman; Wim de Jongh; Henri G D Leuvenink; Arjan D van Zuilen; Bernadette J J M Haase-Kromwijk; Jeroen de Jonge; Stefan P Berger; Sijbrand H Hofker

doi:10.1097/TP.0000000000003845

Hypothermic Machine Perfusion as a National Standard Preservation Method for Deceased Donor Kidneys

Aukje Brat^*, Kirsten M de Vries, Ernst W E van Heurn, Volkert A L Huurman, Wim de Jongh, Henri G D Leuvenink, Arjan D van Zuilen, Bernadette J J M Haase-Kromwijk, Jeroen de Jonge, Stefan P Berger, Sijbrand H Hofker

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Recently, continuous nonoxygenated hypothermic machine perfusion (HMP) has been implemented as standard preservation method for deceased donor kidneys in the Netherlands. This study was designed to assess the effect of the implementation of HMP on early outcomes after transplantation.

METHODS: Kidneys donated in the Netherlands from 2016 to 2017 were intended to be preserved by HMP. A historical cohort (2010-2014) preserved by static cold storage (CS) was chosen as control group. Primary outcome was delayed graft function (DGF). Additional analyses were performed on safety, graft function and survival up until 2 years after transplantation.

RESULTS: Data was collected on 2493 kidneys. Analyses showed significantly more DCD, pre-emptive and retransplants in the project cohort. Of the 681 kidneys that were transplanted during the project, 81% was preserved by HMP. No kidneys were discarded due to HMP related complications. DGF occurred in 38.2% of the project cohort versus 43.7% of the historical cohort (p <0.001), with a significantly shorter duration within the project cohort (7 versus 9 days, p = 0.003). Multivariate regression analysis showed an odds ratio of 0.69 (95% CI 0.553 - 0.855) for the risk of DGF when using HMP compared to CS (p = 0.001). There was no significant difference in kidney function, graft and recipient survival up until 2 years post transplantation.

CONCLUSIONS: This study showed that HMP as standard preservation method for deceased donor kidneys is safe and feasible. HMP was associated with a significant reduction of DGF.

Original language	English
Pages (from-to)	1043-1050
Journal	Transplantation
Volume	106
Issue number	5
Early online date	23-Jun-2021
DOIs	https://doi.org/10.1097/TP.0000000000003845
Publication status	Published - May-2022

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Brat, A., de Vries, K. M., van Heurn, E. W. E., Huurman, V. A. L., de Jongh, W., Leuvenink, H. G. D., van Zuilen, A. D., Haase-Kromwijk, B. J. J. M., de Jonge, J., Berger, S. P., & Hofker, S. H. (2022). Hypothermic Machine Perfusion as a National Standard Preservation Method for Deceased Donor Kidneys. Transplantation, 106(5), 1043-1050. https://doi.org/10.1097/TP.0000000000003845

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title = "Hypothermic Machine Perfusion as a National Standard Preservation Method for Deceased Donor Kidneys",

abstract = "BACKGROUND: Recently, continuous nonoxygenated hypothermic machine perfusion (HMP) has been implemented as standard preservation method for deceased donor kidneys in the Netherlands. This study was designed to assess the effect of the implementation of HMP on early outcomes after transplantation.METHODS: Kidneys donated in the Netherlands from 2016 to 2017 were intended to be preserved by HMP. A historical cohort (2010-2014) preserved by static cold storage (CS) was chosen as control group. Primary outcome was delayed graft function (DGF). Additional analyses were performed on safety, graft function and survival up until 2 years after transplantation.RESULTS: Data was collected on 2493 kidneys. Analyses showed significantly more DCD, pre-emptive and retransplants in the project cohort. Of the 681 kidneys that were transplanted during the project, 81% was preserved by HMP. No kidneys were discarded due to HMP related complications. DGF occurred in 38.2% of the project cohort versus 43.7% of the historical cohort (p <0.001), with a significantly shorter duration within the project cohort (7 versus 9 days, p = 0.003). Multivariate regression analysis showed an odds ratio of 0.69 (95% CI 0.553 - 0.855) for the risk of DGF when using HMP compared to CS (p = 0.001). There was no significant difference in kidney function, graft and recipient survival up until 2 years post transplantation.CONCLUSIONS: This study showed that HMP as standard preservation method for deceased donor kidneys is safe and feasible. HMP was associated with a significant reduction of DGF.",

author = "Aukje Brat and {de Vries}, {Kirsten M} and {van Heurn}, {Ernst W E} and Huurman, {Volkert A L} and {de Jongh}, Wim and Leuvenink, {Henri G D} and {van Zuilen}, {Arjan D} and Haase-Kromwijk, {Bernadette J J M} and {de Jonge}, Jeroen and Berger, {Stefan P} and Hofker, {Sijbrand H}",

year = "2022",

month = may,

doi = "10.1097/TP.0000000000003845",

language = "English",

volume = "106",

pages = "1043--1050",

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T1 - Hypothermic Machine Perfusion as a National Standard Preservation Method for Deceased Donor Kidneys

AU - Brat, Aukje

AU - de Vries, Kirsten M

AU - van Heurn, Ernst W E

AU - Huurman, Volkert A L

AU - de Jongh, Wim

AU - Leuvenink, Henri G D

AU - van Zuilen, Arjan D

AU - Haase-Kromwijk, Bernadette J J M

AU - de Jonge, Jeroen

AU - Berger, Stefan P

AU - Hofker, Sijbrand H

PY - 2022/5

Y1 - 2022/5

N2 - BACKGROUND: Recently, continuous nonoxygenated hypothermic machine perfusion (HMP) has been implemented as standard preservation method for deceased donor kidneys in the Netherlands. This study was designed to assess the effect of the implementation of HMP on early outcomes after transplantation.METHODS: Kidneys donated in the Netherlands from 2016 to 2017 were intended to be preserved by HMP. A historical cohort (2010-2014) preserved by static cold storage (CS) was chosen as control group. Primary outcome was delayed graft function (DGF). Additional analyses were performed on safety, graft function and survival up until 2 years after transplantation.RESULTS: Data was collected on 2493 kidneys. Analyses showed significantly more DCD, pre-emptive and retransplants in the project cohort. Of the 681 kidneys that were transplanted during the project, 81% was preserved by HMP. No kidneys were discarded due to HMP related complications. DGF occurred in 38.2% of the project cohort versus 43.7% of the historical cohort (p <0.001), with a significantly shorter duration within the project cohort (7 versus 9 days, p = 0.003). Multivariate regression analysis showed an odds ratio of 0.69 (95% CI 0.553 - 0.855) for the risk of DGF when using HMP compared to CS (p = 0.001). There was no significant difference in kidney function, graft and recipient survival up until 2 years post transplantation.CONCLUSIONS: This study showed that HMP as standard preservation method for deceased donor kidneys is safe and feasible. HMP was associated with a significant reduction of DGF.

AB - BACKGROUND: Recently, continuous nonoxygenated hypothermic machine perfusion (HMP) has been implemented as standard preservation method for deceased donor kidneys in the Netherlands. This study was designed to assess the effect of the implementation of HMP on early outcomes after transplantation.METHODS: Kidneys donated in the Netherlands from 2016 to 2017 were intended to be preserved by HMP. A historical cohort (2010-2014) preserved by static cold storage (CS) was chosen as control group. Primary outcome was delayed graft function (DGF). Additional analyses were performed on safety, graft function and survival up until 2 years after transplantation.RESULTS: Data was collected on 2493 kidneys. Analyses showed significantly more DCD, pre-emptive and retransplants in the project cohort. Of the 681 kidneys that were transplanted during the project, 81% was preserved by HMP. No kidneys were discarded due to HMP related complications. DGF occurred in 38.2% of the project cohort versus 43.7% of the historical cohort (p <0.001), with a significantly shorter duration within the project cohort (7 versus 9 days, p = 0.003). Multivariate regression analysis showed an odds ratio of 0.69 (95% CI 0.553 - 0.855) for the risk of DGF when using HMP compared to CS (p = 0.001). There was no significant difference in kidney function, graft and recipient survival up until 2 years post transplantation.CONCLUSIONS: This study showed that HMP as standard preservation method for deceased donor kidneys is safe and feasible. HMP was associated with a significant reduction of DGF.

U2 - 10.1097/TP.0000000000003845

DO - 10.1097/TP.0000000000003845

M3 - Article

C2 - 34172648

SN - 0041-1337

VL - 106

SP - 1043

EP - 1050

JO - Transplantation

JF - Transplantation

IS - 5

ER -

Hypothermic Machine Perfusion as a National Standard Preservation Method for Deceased Donor Kidneys

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