title: [Toward a customized preservation for each kidney graft?]
abstract: The increased number of patients in waiting list for renal transplantation requires the establishment of recommendations regarding graft preservation techniques. The preservation method impacts graft function and survival particularly in case of extended criteria donors. Based on our experience, the aim of this review is to establish a decisional diagram to draw graft management to 5years in relation to donor type and graft quality. Novel biomarkers are necessary to evaluate graft quality. Nuclear magnetic resonance or transcriptomic analyses are promising. Thus, good quality organs will be preserved in static condition associated to hypothermia; while grafts from extended criteria donors need to be assessed early during dynamic perfusion through an evaluation of perfusion solution to discriminate: good organs, with acceptable risks without perfusion conditions modifications; tolerable risk grafts for which it will be recommended to use a supplementation of perfusion solution with oxygen or pharmacologic additives such as mitochondrion protectors or oxygen carriers; and elevated risks graft which will not be used. This diagram based on experimental data needs to be assessed in clinical trials but highlights the crucial role of kidney graft quality assessment for its management and placed dynamic perfusion preservation as the protocol of choice for extended criteria donors.
authors.affiliation: Inserm, U1082, IRTOMIT, ischémie-reperfusion en transplantation d'organe, mécanismes et innovations thérapeutiques, faculté de médecine et de pharmacie de Poitiers, université de Poitiers, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France; Service de réanimation chirurgicale, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerforne
authors.affiliation: Inserm, U1082, IRTOMIT, ischémie-reperfusion en transplantation d'organe, mécanismes et innovations thérapeutiques, faculté de médecine et de pharmacie de Poitiers, université de Poitiers, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France; Laboratoire de biochimie, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Favreau
authors.affiliation: Inserm, U1082, IRTOMIT, ischémie-reperfusion en transplantation d'organe, mécanismes et innovations thérapeutiques, faculté de médecine et de pharmacie de Poitiers, université de Poitiers, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France; Laboratoire de biochimie, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Thuillier
authors.affiliation: Inserm, U1082, IRTOMIT, ischémie-reperfusion en transplantation d'organe, mécanismes et innovations thérapeutiques, faculté de médecine et de pharmacie de Poitiers, université de Poitiers, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France; Laboratoire de biochimie, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France; Inra, UE1372 GenESI, plateforme labellisée IBiSA MOPICT, BP 52, Saint-Pierre d'Amilly, 17700 Surgères, France; Fédération hospitalo-universitaire suport, CS90577, 86021 Poitiers, France. Electronic address: thierry.hauet@gmail.com.
authors.forename: Thierry
authors.initials: T
authors.lastname: Hauet
authors.affiliation: Inserm, U1082, IRTOMIT, ischémie-reperfusion en transplantation d'organe, mécanismes et innovations thérapeutiques, faculté de médecine et de pharmacie de Poitiers, université de Poitiers, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France; Service de réanimation chirurgicale, CHU de Poitiers, 2, rue de la Milétrie, CS90577, 86021 Poitiers, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Pinsard
mesh_terms: D015925:Cryopreservation / Q000379:methods; D046148:Donor Selection; D006085:Graft Survival; D017408:Guidelines as Topic; D006801:Humans; D007668:Kidney; D016030:Kidney Transplantation / Q000379:methods; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions / Q000008:administration & dosage; D010477:Perfusion / Q000379:methods
chemical_list: D019188:Organ Preservation Solutions
keywords: Graft quality assessment; Machine perfusion; Perfusion machine; Recommandations; Recommendations; Renal transplantation; Transplantation rénale; Évaluation de la qualité du greffon