Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death

Juergen 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, Guenter R. Kirste, Axel Rahmel, Henri G. D. Leuvenink, Jacques Pirenne, Rutger J. Ploeg, Andreas Paul*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

143 Citations (Scopus)

Abstract

P>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).

Original languageEnglish
Pages (from-to)548-554
Number of pages7
JournalTransplant International
Volume24
Issue number6
DOIs
Publication statusPublished - Jun-2011

Keywords

  • donation
  • expanded donor pool
  • kidney
  • organ preservation and procurement
  • outcome
  • DELAYED GRAFT FUNCTION
  • RENAL-TRANSPLANTATION
  • PULSATILE PRESERVATION
  • ACUTE REJECTION
  • SURVIVAL
  • COSTS

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