title: Application of machine perfusion preservation as a viability test for marginal kidney graft.
abstract: BACKGROUND
  This study evaluated the usefulness of machine perfusion preservation parameters as indicators of kidney graft viability.
  
  
  METHODS
  Eighty-eight cadaveric kidneys were analyzed in this study. Of these, 74 kidneys (84.1%) were procured from nonheartbeating donors. The criteria for an acceptable kidney for transplantation were a perfusion flow of more than 0.4 mL/min/g with a concurrent decreasing perfusion pressure. The average perfusion pressure was 30-50 mmHg. We divided the kidneys into three groups: group 1 (n=35), 0.45-0.65 mL/min/g machine perfusion flow (MPF); group 2 (n=30), 0.65-0.90 mL/min/g MPF; and group 3 (n=23), more than 0.9 mL/min/g MPF.
  
  
  RESULTS
  A higher rate of primary nonfunction (PNF; 25.7%) was found in group 1, compared with 6.7% in group 2 and 0% in group 3. A higher rate of 30.4% immediate function was found in group 3, compared with 16.7% in group and 8.6% in group 1. However, a longer period of acute tubular necrosis (ATN; 12.0 days) was found in group 1 compared with 8.6 days in group 2 and 8.7 days in group 3. PNF was detected in 7 (77.8%) cases with more than 16 hr of total ischemic time (TIT) in group 1. In contrast, all of nine cases with more than 16 hr of TIT in group 3 were functional.
  
  
  CONCLUSIONS
  MPF is a reliable indicator of graft viability based on the rate of PNF and immediate renal allograft function, especially in marginal donors.
authors.affiliation: The 5th Department of Surgery, Hachioji Medical Center of Tokyo Medical University, Tokyo, Japan. mtn@tokyo-med.ac.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Matsuno
authors.forename: Osamu
authors.initials: O
authors.lastname: Konno
authors.forename: Abudushukur
authors.initials: A
authors.lastname: Mejit
authors.forename: Yoshimaro
authors.initials: Y
authors.lastname: Jyojima
authors.forename: Isao
authors.initials: I
authors.lastname: Akashi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Iwamoto
authors.forename: Koichiro
authors.initials: K
authors.lastname: Hama
authors.forename: Toru
authors.initials: T
authors.lastname: Iwahori
authors.forename: Tatsuhito
authors.initials: T
authors.lastname: Ashizawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagao
mesh_terms: D000328:Adult; D002102:Cadaver; D015925:Cryopreservation; D005260:Female; D006801:Humans; D007668:Kidney; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000295:instrumentation*; D010477:Perfusion / Q000295:instrumentation*; D013997:Time Factors; D014019:Tissue Donors; D014022:Tissue Survival