title: Single centre experience of hypothermic machine perfusion of kidneys from extended criteria deceased heart-beating donors: a comparative study.
abstract: BACKGROUND
  Kidneys from extended criteria donors are associated with higher rates of delayed graft function (DGF). Hypothermic machine perfusion (MP) for storage is associated with more favourable outcomes.
  
  
  METHODS
  A retrospective analysis was performed in 93 patients where the kidney was stored using hypothermic MP (LifePort(®)) and compared to an age-matched control group where the kidney was stored in cold static storage (CSS) using University of Wisconsin solution.
  
  
  RESULTS
  Median age was similar in both groups (59.2 years in MP vs 59.9 years in CSS, p = 0.5598). Mean cold storage time was 15.6 h in MP vs 17.9 h in CSS. Post transplant mean serum creatinine was as follows; MP group-144.7 μmol/L at 1 month; 138.3 μmol/L at 3 months and 129.5 μmol/L at 12 months. In the CSS group-163 μmol/L at 1 month; 154.9 μmol/L at 3 months and 140.2 μmol/L at 12 months. There was a statistically significant difference at 1 month (p = 0.0096) and 3 months (p = 0.0236). DGF was defined as the need for haemodialysis within 7 days post transplant. In the MP group, DGF occurred in 17.2 % patients with mean of 6 days (range 1-18). In the CSS group, 25.8 % patients with mean of 8.1 days (range 3-25). One-year graft survival rate was better in the MP group (97.85 vs 96.77 %).
  
  
  CONCLUSIONS
  Our experience to date recommends the use of hypothermic MP for storage of kidneys from extended criteria deceased heart-beating donors.
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland. fordejames@yahoo.com.|Department of Urology and Transplantation, Beaumont Hospital, Dublin 9, Ireland. fordejames@yahoo.com.
authors.forename: J C
authors.initials: JC
authors.lastname: Forde
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: W P
authors.initials: WP
authors.lastname: Shields
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Azhar
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: P J
authors.initials: PJ
authors.lastname: Daly
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: J A
authors.initials: JA
authors.lastname: Zimmermann
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: G P
authors.initials: GP
authors.lastname: Smyth
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: M P
authors.initials: MP
authors.lastname: Eng
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: R E
authors.initials: RE
authors.lastname: Power
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Mohan
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: D P
authors.initials: DP
authors.lastname: Hickey
authors.affiliation: National Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland.
authors.forename: D M
authors.initials: DM
authors.lastname: Little
mesh_terms: D000241:Adenosine; D000368:Aged; D000493:Allopurinol; D015925:Cryopreservation / Q000379:methods*; D051799:Delayed Graft Function; D005260:Female; D005978:Glutathione; D006085:Graft Survival; D006801:Humans; D007328:Insulin; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D010477:Perfusion / Q000379:methods*; D011887:Raffinose; D012189:Retrospective Studies; D009927:Tissue and Organ Procurement / Q000379:methods*
chemical_list: D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose
keywords: Extended criteria donor; Hypothermic machine perfusion; Kidney transplant; Outcome