The early and long term function and survival of kidney allografts stored before transplantation by hypothermic pulsatile perfusion. A prospective randomized study.
BACKGROUND
A prospective evaluation of the influence of methods of kidney storage prior to transplantation on long-term graft function has not been shown so far. A retrospective study undertaken in 415 patients in our department showed the benefit of machine perfusion (MP) on long-term results. The aim of the present study was to assess prospectively the long term function and survival of paired kidney allografts retrieved from the same donor, comparing the influence of cold storage (CS) and MP.


METHODS
74 recipients included in the study received kidneys from 37 cadaveric donors. Kidneys were randomized to storage by CS or MP. There were no significant differences between the groups as to age, gender, duration of ESRD treatment, PRA titres, HLA compatibility and immunosuppressive regimens.


RESULTS
At 10 years follow-up recipients of CS-stored kidneys returned to dialysis treatment twice as frequently as recipients of MP-stored kidneys (50% vs. 25%, p=0.02).


CONCLUSIONS
Kidney storage by MP improves graft survival and reduces the number of patients who return to dialysis treatment at long-term post-transplant.
Kwiatkowski
Artur
A
Department of General and Transplantation Surgery, Warsaw Medical University, Poland.
Wszoła
Michal
M
Kosieradzki
Maciej
M
Danielewicz
Roman
R
Ostrowski
Krzysztof
K
Domagala
Piotr
P
Lisik
Wojciech
W
Fesołowicz
Slawomir
S
Michalak
Grzegorz
G
Trzebicki
Janusz
J
Durlik
Magdalena
M
Paczek
Leszek
L
Rowiński
Wojciech
W
Chmura
Andrzej
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D051799:Delayed Graft Function / Q000453:epidemiology*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007035:Hypothermia; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000473:pathology / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods; D010477:Perfusion; D011446:Prospective Studies; D011673:Pulsatile Flow; D006435:Renal Dialysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult