title: Machine perfusion versus cold storage of kidneys derived from donation after cardiac death: a meta-analysis.
abstract: BACKGROUND
  In response to the increased organ shortage, organs derived from donation after cardiac death (DCD) donors are becoming an acceptable option once again for clinical use in transplantation. However, transplant outcomes in cases where DCD organs are used are not as favorable as those from donation after brain death or living donors. Different methods of organ preservation are a key factor that may influence the outcomes of DCD kidney transplantation.
  
  
  METHODS
  We compared the transplant outcomes in patients receiving DCD kidneys preserved by machine perfusion (MP) or by static cold storage (CS) preservation by conducting a meta-analysis. The MEDLINE, EMBASE and Cochrane Library databases were searched. All studies reporting outcomes for MP versus CS preserved DCD kidneys were further considered for inclusion in this meta-analysis. Odds ratios and 95% confidence intervals (CI) were calculated to compare the pooled data between groups that were transplanted with kidneys that were preserved by MP or CS.
  
  
  RESULTS
  Four prospective, randomized, controlled trials, involving 175 MP and 176 CS preserved DCD kidney transplant recipients, were included. MP preserved DCD kidney transplant recipients had a decreased incidence of delayed graft function (DGF) with an odd ration of 0.56 (95% CI = 0.36-0.86, P = 0.008) compared to CS. However, no significant differences were seen between the two technologies in incidence of primary non-function, one year graft survival, or one year patient survival.
  
  
  CONCLUSIONS
  MP preservation of DCD kidneys is superior to CS in terms of reducing DGF rate post-transplant. However, primary non-function, one year graft survival, and one year patient survival were not affected by the use of MP or CS for preservation.
authors.affiliation: Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Ronghai
authors.initials: R
authors.lastname: Deng
authors.forename: Guangxiang
authors.initials: G
authors.lastname: Gu
authors.forename: Dongping
authors.initials: D
authors.lastname: Wang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Tai
authors.forename: Linwei
authors.initials: L
authors.lastname: Wu
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Ju
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zhu
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Guo
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: He
mesh_terms: D002423:Cause of Death; D015925:Cryopreservation / Q000379:methods; D003643:Death; D006085:Graft Survival; D006801:Humans; D007668:Kidney; D016030:Kidney Transplantation; D016017:Odds Ratio; D009926:Organ Preservation / Q000379:methods*; D063868:Patient Outcome Assessment; D010477:Perfusion / Q000379:methods; D014019:Tissue Donors
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