The Impact of Hypothermic Pulsatile Machine Perfusion Versus Static Cold Storage: A Donor-Matched Paired Analysis in a Scenario of High Incidence of Delayed Kidney Graft Function.

Content Provider	Europe PMC
Author	de Sandes-Freitas, Tainá Veras Costa, Silvana Daher de Andrade, Luís Gustavo Modelli Girão, Celi Melo Fernandes, Paula Frassinetti C.B.C. de Oliveira, Claudia Maria Costa de Matos Esmeraldo, Ronaldo
Copyright Year	2020
Abstract	BackgroundThe present study analyzed the impact of hypothermic pulsatile machine perfusion (MP) following a long period of static cold (SC) storage in the peculiar Brazilian scenario of high incidence of delayed graft function (DGF), despite good donor characteristics.Material/MethodsA retrospective analysis, with a 1-year follow-up, of 206 recipients of donor-matched paired kidneys was performed. Of the 206 donor kidneys, 103 were maintained exclusively in static cold storage (SC group) and 103 were kept on machine perfusion after a period of SC preservation (MP group). All donors were brain dead.ResultsOnly 4.9% of the kidneys were from expanded-criteria donors. Static cold ischemia time (CIT) in the SC group was 20.8±4.1 hours vs. 15.8±6.2 hours in the MP group (P<0.001). Dynamic CIT in the MP group was 12.3±5.7 hours. MP significantly reduced DGF incidence (29.1% vs. 55.3%, P<0.001), and this effect was confirmed in multivariable analysis (OR, 1.115; 95% CI, 1.033–1.204, P=0.001). No differences were observed between the groups with regard to DGF duration, length of hospital stay, incidence of primary nonfunction and acute rejection, graft loss, death, or renal function.ConclusionsIn this Brazilian setting, MP following a long period of SC preservation was associated with reduced DGF incidence in comparison with SC storage without MP.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7749524&blobtype=pdf
ISSN	14259524
Journal	Annals of Transplantation [Ann Transplant]
Volume Number	25
PubMed Central reference number	PMC7749524
PubMed reference number	33318465
e-ISSN	23290358
DOI	10.12659/aot.927010
Language	English
Publisher	International Scientific Literature, Inc.
Publisher Date	2020-12-15
Access Restriction	Open
Rights License	This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) © Ann Transplant, 2020
Subject Keyword	Delayed Graft Function Organ Preservation Pulsatile Flow
Content Type	Text
Resource Type	Article
Subject	Transplantation