Immediate function and cost comparison between static and pulsatile preservation in kidney recipients.
During a 1-yr period between September 1993 and September 1994, 74 patients received cadaveric kidney transplants at our institution. Thirty nine (39) kidneys were cold stored (CS), while 35 received pulsatile preservation (PP) on the Water's Mox system using U.W. Machine Preservation Solution. A perfusionist maintained pressure, flows, pH, and osmolality, within accepted ranges. Vasodilators (Regitine, Stelazine, Verapamil) were routinely added to the machine preservation solution. Most kidneys on PP were from marginal donors, or were imported and had associated long ice storage times. The CS kidneys, however, were from "ideal donors" where immediate function (IF) was expected. The kidneys were transplanted using a common protocol by a variety of surgeons. PP was associated with higher IF rates, shorter hospital stay and decreased overall costs. The function of those kidneys was also compared with the mate kidneys, obtained through a telephone survey of the various transplant centers throughout the country. PP was again associated with higher immediate function rates.
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Washington Hospital Center, Medlantic Research Institute/Howard University Hospital Organ Preservation Laboratory, Washington, D.C. 20010, USA.
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Kowalski
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Sasaki
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D000241:Adenosine; D000293:Adolescent; D000328:Adult; D000368:Aged; D000493:Allopurinol; D002102:Cadaver; D002648:Child; D003080:Cold Temperature; D003365:Costs and Cost Analysis; D005978:Glutathione; D006801:Humans; D007328:Insulin; D007668:Kidney / Q000502:physiology; D016030:Kidney Transplantation / Q000191:economics*; D008875:Middle Aged; D009926:Organ Preservation / Q000191:economics* / Q000379:methods*; D019188:Organ Preservation Solutions; D011673:Pulsatile Flow; D011887:Raffinose
D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose