Single Centre Experience of Hypothermic Machine Perfusion of Kidneys from Extended Criteria Deceased Heart-beating Donors: a Comparative Study

Overview

Journal Ir J Med Sci

Specialty General Medicine

Date 2014 Dec 5

PMID 25472824

Citations 4

Authors

J C Forde

W P Shields

M Azhar

P J Daly

J A Zimmermann

G P Smyth

M P Eng

R E Power

P Mohan

D P Hickey

D M Little

Affiliations

Soon will be listed here.

Abstract

Introduction: Kidneys from extended criteria donors are associated with higher rates of delayed graft function (DGF). Hypothermic machine perfusion (MP) for storage is associated with more favourable outcomes.

Methods: A retrospective analysis was performed in 93 patients where the kidney was stored using hypothermic MP (LifePort(®)) and compared to an age-matched control group where the kidney was stored in cold static storage (CSS) using University of Wisconsin solution.

Results: Median age was similar in both groups (59.2 years in MP vs 59.9 years in CSS, p = 0.5598). Mean cold storage time was 15.6 h in MP vs 17.9 h in CSS. Post transplant mean serum creatinine was as follows; MP group-144.7 μmol/L at 1 month; 138.3 μmol/L at 3 months and 129.5 μmol/L at 12 months. In the CSS group-163 μmol/L at 1 month; 154.9 μmol/L at 3 months and 140.2 μmol/L at 12 months. There was a statistically significant difference at 1 month (p = 0.0096) and 3 months (p = 0.0236). DGF was defined as the need for haemodialysis within 7 days post transplant. In the MP group, DGF occurred in 17.2 % patients with mean of 6 days (range 1-18). In the CSS group, 25.8 % patients with mean of 8.1 days (range 3-25). One-year graft survival rate was better in the MP group (97.85 vs 96.77 %).

Conclusion: Our experience to date recommends the use of hypothermic MP for storage of kidneys from extended criteria deceased heart-beating donors.

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References

Kim J, Kim S, Joh J, Kwon C, Song S, Shin M . Is it safe to use a kidney from an expanded criteria donor?. Transplant Proc. 2011; 43(6):2359-62. DOI: 10.1016/j.transproceed.2011.05.040. View

Port F, Bragg-Gresham J, Metzger R, Dykstra D, Gillespie B, Young E . Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors. Transplantation. 2002; 74(9):1281-6. DOI: 10.1097/00007890-200211150-00014. View

Matsuno N, Konno O, Mejit A, Jyojima Y, Akashi I, Nakamura Y . Application of machine perfusion preservation as a viability test for marginal kidney graft. Transplantation. 2006; 82(11):1425-8. DOI: 10.1097/01.tp.0000243733.77706.99. View

Ojo A, Hanson J, Meier-Kriesche H, Okechukwu C, Wolfe R, Leichtman A . Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J Am Soc Nephrol. 2001; 12(3):589-597. DOI: 10.1681/ASN.V123589. View

Gomez V, Galeano C, Diez V, Bueno C, Diaz F, Burgos F . Economic impact of the introduction of machine perfusion preservation in a kidney transplantation program in the expanded donor era: cost-effectiveness assessment. Transplant Proc. 2012; 44(9):2521-4. DOI: 10.1016/j.transproceed.2012.09.065. View

Moers C, Smits J, Maathuis M, Treckmann J, Van Gelder F, Napieralski B . Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med. 2009; 360(1):7-19. DOI: 10.1056/NEJMoa0802289. View

Yarlagadda S, Coca S, Garg A, Doshi M, Poggio E, Marcus R . Marked variation in the definition and diagnosis of delayed graft function: a systematic review. Nephrol Dial Transplant. 2008; 23(9):2995-3003. PMC: 2727302. DOI: 10.1093/ndt/gfn158. View

Pascual J, Zamora J, Pirsch J . A systematic review of kidney transplantation from expanded criteria donors. Am J Kidney Dis. 2008; 52(3):553-86. DOI: 10.1053/j.ajkd.2008.06.005. View

Mas V, Archer K, Dumur C, Scian M, Suh J, King A . Reduced expression of inflammatory genes in deceased donor kidneys undergoing pulsatile pump preservation. PLoS One. 2012; 7(4):e35526. PMC: 3335841. DOI: 10.1371/journal.pone.0035526. View

10.

Matsuno N, Konno Y, Jyojima Y, Akashi I, Iwamoto H, Hama K . Machine perfusion preservation for kidney grafts with a high creatinine from uncontrolled donation after cardiac death. Transplant Proc. 2010; 42(1):155-8. DOI: 10.1016/j.transproceed.2009.11.024. View

11.

Karpinski J, Lajoie G, Cattran D, Fenton S, Zaltzman J, Cardella C . Outcome of kidney transplantation from high-risk donors is determined by both structure and function. Transplantation. 1999; 67(8):1162-7. DOI: 10.1097/00007890-199904270-00013. View

12.

Port F . Organ donation and transplantation trends in the United States, 2001. Am J Transplant. 2003; 3 Suppl 4:7-12. DOI: 10.1034/j.1600-6143.3.s4.2.x. View

13.

OCallaghan J, Morgan R, Knight S, Morris P . Systematic review and meta-analysis of hypothermic machine perfusion versus static cold storage of kidney allografts on transplant outcomes. Br J Surg. 2013; 100(8):991-1001. DOI: 10.1002/bjs.9169. View

14.

Bond M, Pitt M, Akoh J, Moxham T, Hoyle M, Anderson R . The effectiveness and cost-effectiveness of methods of storing donated kidneys from deceased donors: a systematic review and economic model. Health Technol Assess. 2009; 13(38):iii-iv, xi-xiv, 1-156. DOI: 10.3310/hta13380. View

15.

Stratta R, Sundberg A, Rohr M, Farney A, Hartmann E, Roskopf J . Optimal use of older donors and recipients in kidney transplantation. Surgery. 2006; 139(3):324-33. DOI: 10.1016/j.surg.2005.09.032. View

16.

. Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients 2010 data report. Am J Transplant. 2011; 12 Suppl 1:1-156. DOI: 10.1111/j.1600-6143.2011.03886.x. View

17.

Goh C, Ladouceur M, Peters L, Desmond C, Tchervenkov J, Baran D . Lengthy cold ischemia time is a modifiable risk factor associated with low glomerular filtration rates in expanded criteria donor kidney transplant recipients. Transplant Proc. 2009; 41(8):3290-2. DOI: 10.1016/j.transproceed.2009.09.035. View

18.

Treckmann J, Moers C, Smits J, Gallinat A, Maathuis M, van Kasterop-Kutz M . Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death. Transpl Int. 2011; 24(6):548-54. DOI: 10.1111/j.1432-2277.2011.01232.x. View

19.

Gaber L, Moore L, Alloway R, Amiri M, Vera S, Gaber A . Glomerulosclerosis as a determinant of posttransplant function of older donor renal allografts. Transplantation. 1995; 60(4):334-9. DOI: 10.1097/00007890-199508270-00006. View

20.

Sedigh A, Tufveson G, Backman L, Biglarnia A, Lorant T . Initial experience with hypothermic machine perfusion of kidneys from deceased donors in the Uppsala region in Sweden. Transplant Proc. 2013; 45(3):1168-71. DOI: 10.1016/j.transproceed.2012.10.017. View