scholarly journals A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation

2020 ◽  
Vol 9 (7) ◽  
pp. 2311
Author(s):  
Silvia Gasteiger ◽  
Valeria Berchtold ◽  
Claudia Bösmüller ◽  
Lucie Dostal ◽  
Hanno Ulmer ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Propensity Score ◽  
Graft Survival ◽  
Cold Storage ◽  
Strong Predictor ◽  
Graft Function ◽  
Machine Perfusion ◽  
Hypothermic Machine Perfusion ◽  
Increased Risk ◽  
Matching Criteria

Hypothermic machine perfusion (HMP) has been introduced as an alternative to static cold storage (SCS) in kidney transplantation, but its true benefit in the clinical routine remains incompletely understood. The aim of this study was to assess the effect of HMP vs. SCS in kidney transplantation. All kidney transplants performed between 08/2015 and 12/2019 (n = 347) were propensity score (PS) matched for cold ischemia time (CIT), extended criteria donor (ECD), gender mismatch, cytomegalovirus (CMV) mismatch, re-transplantation and Eurotransplant (ET) senior program. A total of 103 HMP and 103 SCS instances fitted the matching criteria. Prior to PS matching, the CIT was longer in the HMP group (17.5 h vs. 13.3 h; p < 0.001), while the delayed graft function (DGF) rates were 29.8% and 32.3% in HMP and SCS, respectively. In the PS matched groups, the DGF rate was 64.1% in SCS vs. 31.1% following HMP: equivalent to a 51.5% reduction of the DGF rate (OR 0.485, 95% CI 0.318–0.740). DGF was associated with decreased 1- and 3-year graft survival (100% and 96.3% vs. 90.8% and 86.7%, p = 0.001 and p = 0.008) or a 4.1-fold increased risk of graft failure (HR = 4.108; 95% CI: 1.336–12.631; p = 0.014). HMP significantly reduces DGF in kidney transplantation. DGF remains a strong predictor of graft survival.

Time of Cold Storage Prior to Start of Hypothermic Machine Perfusion and Its Influence on Graft Survival

2019 ◽  
Vol 51 (8) ◽  
pp. 2514-2519
Author(s):  
Michal Wszola ◽  
Piotr Domagala ◽  
Agata Ostaszewska ◽  
Lukasz Gorski ◽  
Edyta Karpeta ◽  
...  
Keyword(s):  
Graft Survival ◽  
Cold Storage ◽  
Machine Perfusion ◽  
Hypothermic Machine Perfusion

Hypothermic Machine Perfusion in DCD Kidney Transplantation: A Single Center Experience

2015 ◽  
Vol 96 (2) ◽  
pp. 148-151 ◽  
Author(s):  
Liyu Yao ◽  
Honglan Zhou ◽  
Yuantao Wang ◽  
Gang Wang ◽  
Weigang Wang ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Postoperative Recovery ◽  
Donation After Cardiac Death ◽  
Machine Perfusion ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Single Center Experience ◽  
Hypothermic Machine Perfusion ◽  
Significant Difference

Introduction: Donation after cardiac death (DCD) began in 2011 after the program hosted by the First Affiliated Hospital of Sun Yat-sen University in China. The aim of this study is to report on our experience regarding the method of preserving donated kidneys for DCD kidney transplantation. Material and Methods: A total of 37 donors and 73 primary kidney transplant recipients during the period 2011-2014 in the Urology Center of the First Hospital of Jilin University were enrolled in the study. Recipients were assigned to traditional static cold storage (SCS) group and hypothermic machine perfusion (HMP) group based on the preservation environment of donated kidneys after organ harvest. Clinical data were collected for each group. Result: The HMP group had a lower rate of delayed graft function (DGF), better postoperative recovery and kidney function compared with that of SCS group. There is no significant difference in postoperative rejection incidence between the 2 groups. Conclusions: DCD kidneys stored by hypothermic machine contribute to a lower rate of DGF and promoted the rehabilitation progress.

Normothermic Ex Vivo Kidney Perfusion Improves Early DCD Graft Function Compared With Hypothermic Machine Perfusion and Static Cold Storage

2020 ◽  
Vol 104 (5) ◽  
pp. 947-955 ◽  
Author(s):  
Peter Urbanellis ◽  
Matyas Hamar ◽  
J. Moritz Kaths ◽  
Dagmar Kollmann ◽  
Ivan Linares ◽  
...  
Keyword(s):  
Cold Storage ◽  
Ex Vivo ◽  
Graft Function ◽  
Machine Perfusion ◽  
Hypothermic Machine Perfusion ◽  
Kidney Perfusion

Machine Perfusion Following Static Cold Storage in Kidney Transplantation Decreases the Duration of Delayed Graft Function and Time to Hospital Discharge.

2014 ◽  
Vol 98 ◽  
pp. 598
Author(s):  
A. Pacheco-Silva ◽  
Borrelli M. Junior ◽  
L. Moura-Requiao ◽  
Souza M. Durao Junior ◽  
Nogueira M. Junior ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Hospital Discharge ◽  
Cold Storage ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Machine Perfusion

scholarly journals Cold Pulsatile Machine Perfusion versus Static Cold Storage in Kidney Transplantation: A Single Centre Experience

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Maria Irene Bellini ◽  
Sotiris Charalampidis ◽  
Paul Elliot Herbert ◽  
Vasileios Bonatsos ◽  
Jeremy Crane ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Survival ◽  
Cold Storage ◽  
Graft Function ◽  
Area Under The Curve ◽  
Length Of Hospital Stay ◽  
Machine Perfusion ◽  
Transplant Outcomes ◽  
One Year ◽  
Patient And Graft Survival

Introduction. We present our experience with hypothermic machine perfusion (HMP) versus cold storage (CS) in relation to kidney transplant outcomes. Methods. Retrospective analysis of 33 consecutive HMP kidney transplant outcomes matched with those of 33 cold stored: delayed graft function (DGF), length of hospital stay (LOS), estimated glomerular filtration rate (eGFR), and patient and graft survival were compared. Renal Resistive Indexes (RIs) during HMP in relation to DGF were also analysed. Results. In the HMP group, mean HMP time was 5.7 ± 3.9 hours with a mean cold ischaemic time (CIT) of 15 ± 5.6 versus 15.1 ± 5.3 hours in the CS group. DGF was lower in the HMP group (p=0.041), and donation after Circulatory Death (DCD) was a predictor for DGF (p<0.01). HMP decreased DGF in DCD grafts (p=0.036). Patient and graft survival were similar, but eGFR at 365 days was higher in the HMP cohort (p<0.001). RIs decreased during HMP (p<0.01); 2-hours RI ≥ 0.45 mmHg/mL/min predicted DGF in DCD kidneys (75% sensitivity, 80% specificity; area under the curve 0.78); 2-hours RI ≥ 0.2 mmHg/ml/min predicted DGF in DBD grafts (sensitivity 100%, specificity 91%; area under the curve 0.87). Conclusion. HMP decreased DGF compared to CS, offering viability assessment pretransplant and improving one-year renal function of the grafts.

scholarly journals Predictive Score Model for Delayed Graft Function Based on Hypothermic Machine Perfusion Variables in Kidney Transplantation

2018 ◽  
Vol 131 (22) ◽  
pp. 2651-2657 ◽  
Author(s):  
Chen-Guang Ding ◽  
Yang Li ◽  
Xiao-Hui Tian ◽  
Xiao-Jun Hu ◽  
Pu-Xun Tian ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Predictive Score ◽  
Machine Perfusion ◽  
Hypothermic Machine Perfusion ◽  
Score Model
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