Comparison of pulsatile perfusion and cold storage for paired kidney allografts.
Use of pulsatile perfusion to optimize outcomes in deceased donor kidney transplantation remains controversial. This study is a retrospective analysis of all cadaveric renal allografts procured locally by our center over a 3-year period. Kidney pairs were identified in which one kidney underwent pulsatile perfusion and transplantation at our center, whereas the contra-lateral kidney underwent cold storage and transplantation at another center. Eighty-eight percent of the exported kidneys were six-antigen matches. Study outcomes included 1-year graft and patient survival, delayed graft function, and need for posttransplant dialysis. Recipients had similar demographic and disease characteristics. Survival for pulsatile perfusion and cold storage were 95% and 88% (graft, P=0.43) and 98% and 90% (patient, P=0.36), respectively. The incidence of delayed graft function was 5% and 35% (P<0.01), whereas posttransplant dialysis was 5% and 30% (P<0.01), for pulsatile perfusion and cold storage, respectively. These data support routine use of pulsatile perfusion.
Department of Surgery, Transplant Division, Indiana University School of Medicine, Indianapolis, IN 46202-5250, USA. apshah@iupui.edu
Ashesh P
AP
Shah
Daniel P
DP
Milgrom
Richard S
RS
Mangus
John A
JA
Powelson
William C
WC
Goggins
Milgrom L
ML
Milgrom
D000328:Adult; D002102:Cadaver; D003080:Cold Temperature; D051799:Delayed Graft Function / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000379:methods; D044469:Racial Groups; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome