title: Hypothermic machine perfusion improves Doppler ultrasonography resistive indices and long-term allograft function after renal transplantation: a single-centre analysis.
abstract: OBJECTIVE
  To evaluate whether hypothermic machine perfusion (HMP) of transplanted kidneys can improve long-term renal allograft function compared with static cold storage (CS).
  
  
  METHODS
  We evaluated whether graft Doppler ultrasonography resistive indices improved with the use of HMP compared with CS preservation, and examined whether these improvements were predictive of long-term graft function. A total of 30 kidney transplants (15 pairs) were examined. One of the kidney pairs was placed on CS and transplanted first (CS group, n = 15). The other kidney of each pair was placed on HMP and transplanted after the CS group (HMP group, n = 15). Doppler ultrasonography was performed on days 1 and 7 after transplantation and resistive indices were evaluated. The estimated glomerular filtration rate (eGFR) was monitored for 24 months after transplantation.
  
  
  RESULTS
  Despite longer cold ischaemia times, kidneys maintained with HMP had lower resistive indices (P = 0.005) with correspondingly higher eGFR throughout the follow-up. Subgroup analysis showed that the HMP-induced improvement in postoperative eGFR was greatest in kidneys obtained from donation after cardiac death (DCD), even at 2 years after transplantation (P = 0.008).
  
  
  CONCLUSIONS
  HMP of transplant kidneys appears to improve vascular resistance after transplantation and has a positive impact on long-term allograft function compared with CS in the population of recipients of DCD kidneys.
authors.affiliation: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.
authors.forename: Marie S
authors.initials: MS
authors.lastname: Dion
authors.affiliation: Department of Surgery, Division of Urology, University of Manitoba, Winnepeg, Manitoba, Canada.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: McGregor
authors.affiliation: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.|Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
authors.forename: Vivian C
authors.initials: VC
authors.lastname: McAlister
authors.affiliation: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.|Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.|Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center, London, Ontario, Canada.
authors.forename: Patrick P
authors.initials: PP
authors.lastname: Luke
authors.affiliation: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.|Department of Microbiology and Immunology, Western University, London, Ontario, Canada.|Center for Human Immunology, Western University, London, Ontario, Canada.|Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.|Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center, London, Ontario, Canada.
authors.forename: Alp
authors.initials: A
authors.lastname: Sener
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts / Q000000981:diagnostic imaging* / Q000502:physiology*; D015925:Cryopreservation / Q000379:methods; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000379:methods*; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler
keywords: Doppler ultrasonography; graft function; hypothermic mechanical perfusion; organ preservation; renal transplantation