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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Transplant+Direct
2017 ; 3
(5
): e155
Nephropedia Template TP
gab.com Text
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English Wikipedia
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of
Deceased Donor Kidney Transplants With High Incidence of Delayed Graft Function
#MMPMID28573190
Tedesco-Silva H Junior
; Mello Offerni JC
; Ayres Carneiro V
; Ivani de Paula M
; Neto ED
; Brambate Carvalhinho Lemos F
; Requião Moura LR
; Pacheco E Silva Filho A
; de Morais Cunha MF
; Francisco da Silva E
; Miorin LA
; Demetrio DP
; Luconi PS
; da Silva Luconi WT
; Bobbio SA
; Kuschnaroff LM
; Noronha IL
; Braga SL
; Barsante RC
; Mendes Moreira JC
; Fernandes-Charpiot IMM
; Abbud-Filho M
; Modelli de Andrade LG
; Dalsoglio Garcia P
; Tanajura Santamaria Saber L
; Fernandes Laurindo A
; Chocair PR
; Cuvello Neto AL
; Zanocco JA
; Duboc de Almeida Soares Filho AJ
; Ferreira Aguiar W
; Medina Pestana J
Transplant Direct
2017[May]; 3
(5
): e155
PMID28573190
show ga
BACKGROUND: This study compared the use of static cold storage versus continuous
hypothermic machine perfusion in a cohort of kidney transplant recipients at high
risk for delayed graft function (DGF). METHODS: In this national, multicenter,
and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased
donors were randomized to cold storage or machine perfusion, transplanted, and
followed up for 12 months. The primary endpoint was the incidence of DGF.
Secondary endpoints included the duration of DGF, hospital stay, primary
nonfunction, estimated glomerular filtration rate, acute rejection, and allograft
and patient survivals. RESULTS: Mean cold ischemia time was high but not
different between the 2 groups (25.6 ± 6.6 hours vs 25.05 ± 6.3 hours, 0.937).
The incidence of DGF was lower in the machine perfusion compared with cold
storage group (61% vs. 45%, P = 0.031). Machine perfusion was independently
associated with a reduced risk of DGF (odds ratio, 0.49; 95% confidence interval,
0.26-0.95). Mean estimated glomerular filtration rate tended to be higher at day
28 (40.6 ± 19.9 mL/min per 1.73 m(2) vs 49.0 ± 26.9 mL/min per 1.73 m(2); P =
0.262) and 1 year (48.3 ± 19.8 mL/min per 1.73 m(2) vs 54.4 ± 28.6 mL/min per
1.73 m(2); P = 0.201) in the machine perfusion group. No differences in the
incidence of acute rejection, primary nonfunction (0% vs 2.5%), graft loss (7.5%
vs 10%), or death (8.8% vs 6.3%) were observed. CONCLUSIONS: In this cohort of
recipients of deceased donor kidneys with high mean cold ischemia time and high
incidence of DGF, the use of continuous machine perfusion was associated with a
reduced risk of DGF compared with the traditional cold storage preservation
method.