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

被引:25
作者
Bellini, Maria Irene [1 ,2 ]
Charalampidis, Sotiris [1 ]
Herbert, Paul Elliot [1 ,2 ]
Bonatsos, Vasileios [2 ]
Crane, Jeremy [1 ,2 ]
Muthusamy, Anand [1 ,2 ]
Dor, Frank J. M. F. [1 ,2 ]
Papalois, Vassilios [1 ,2 ]
机构
[1] Imperial Coll Healthcare NHS Trust, Hammersmith Hosp, Imperial Coll Renal & Transplant Ctr, London, England
[2] Imperial Coll London, Dept Surg, London, England
关键词
DELAYED GRAFT FUNCTION; RENAL RESISTANCE; RISK-FACTORS;
D O I
10.1155/2019/7435248
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
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.
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页数:8
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