Short-term outcome of kidney transplants from non-heart-beating donors after preservation by machine perfusion.
In this study, the short-term outcome of renal transplants from non-heart-beating donors (NHBD) preserved by machine perfusion (MP) is evaluated and compared to preservation by cold storage (CS). Twenty-two NHBD kidneys were procured during 1993 and 1994 after in situ perfusion with histidine-tryptophan ketoglutarate and preserved by continuous perfusion using University of Wisconsin organ preservation solution for MP as a perfusate. Between 1980 and 1992, 57 NHBD kidneys were procured and preserved by CS. Donors in the MP group sustained increased first warm ischemia times (WIT1) (P < 0.1) and recipients in the MP group suffered longer anastomosis time, worse HLA-DR mismatch, and more initial use of cyclosporin as immunosuppressant; all these factors are known to be deleterious to short-term outcome. Despite these unfavorable conditions, delayed function (DF) rate was decreased in the MP group, although not significantly. However, when considering only kidneys with WIT1 > or = 45 min, short-term outcome was significantly better in the MP group (P < 0.05). We conclude that MP is superior for the preservation of NHBD kidneys, especially after prolonged warm ischemia.
Daemen
J H
JH
Department of Surgery, University Hospital Maastricht, The Netherlands.
de Wit
R J
RJ
Bronkhorst
M W
MW
Marcar
M L
ML
Yin
M
M
Heineman
E
E
Kootstra
G
G
D000328:Adult; D003080:Cold Temperature; D006321:Heart / Q000503:physiopathology; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D009926:Organ Preservation; D010477:Perfusion; D014019:Tissue Donors