title: Pulsatile perfusion preservation for expanded-criteria donors kidneys: Impact on delayed graft function rate.
abstract: OBJECTIVE
  Expanded criteria donors (ECD) kidneys are a potential solution to organ shortage, but exhibit more delayed graft function (DGF). We conducted a prospective controlled study aiming to evaluate the impact of pulsatile perfusion preservation (PPP) on DGF rate.
  
  
  METHODS
  Inclusion criteria were: 1) ECD definition (any brain-dead donor aged > 60 years or aged 50-60 years with at least 2 of the following: history of hypertension, terminal serum creatinin level = 1.5 mg/dL, death resulting from a cerebrovascular accident; 2) Donor prolonged circulatory arrest (> 20 mn); 3) previsible cold ischemia time longer than 24 hours. In each pair of kidneys, one organ was preserved with PPP and the other organ was preserved in static cold storage.
  
  
  RESULTS
  From February 2007 to September 2009, a total of 22 donors (44 recipients) were included. Recipients were comparable in the two groups with respect to demographic and immunological data. The rate of DGF was significantly lower (9% vs. 31.8%, p = 0.021) in the PPP group. At 1, 3, and 12 months, renal function was comparable in the two groups.
  
  
  CONCLUSIONS
  Pulsatile perfusion preservation significantly reduced DGF rate in ECD kidney transplantation.
authors: Nephrology and Transplantation, Saint Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France. imad.abboud@sls.aphp.fr
authors: Imad
authors: I
authors: Abboud
authors: Corinne
authors: C
authors: Antoine
authors: François
authors: F
authors: Gaudez
authors: Fabienne
authors: F
authors: Fieux
authors: Carmen
authors: C
authors: Lefaucheur
authors: Evangéline
authors: E
authors: Pillebout
authors: Denis
authors: D
authors: Viglietti
authors: Tomas
authors: T
authors: Serrato
authors: Jérôme
authors: J
authors: Vérine
authors: Martin
authors: M
authors: Flamant
authors: Marie-Noëlle
authors: MN
authors: Peraldi
authors: Denis
authors: D
authors: Glotz
mesh_terms: D000328:Adult; D000368:Aged; D050377:Cold Ischemia; D003080:Cold Temperature; D051799:Delayed Graft Function / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005602:France; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019188:Organ Preservation Solutions; D010477:Perfusion / Q000009:adverse effects / Q000401:mortality; D011446:Prospective Studies; D011673:Pulsatile Flow; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome
chemical_list: D019188:Organ Preservation Solutions