donation; expanded donor pool; kidney; organ pradervation and procurement; outcome
Abstract :
[en] 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 heartbeating
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.
Disciplines :
Surgery
Author, co-author :
Treckmann, Jürgen
Moers, Cyril
Smits, Jacqueline M
Gallinat, Anja
Maathuis, Mark-Hugo J
van Kasterop-Kutz, Margitta
Jochmans, Ina
Homan van der Heide, Jaap J
SQUIFFLET, Jean-Paul ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
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