title: Evaluation of quality of kidneys from donation after circulatory death/expanded criteria donors by parameters of machine perfusion.
abstract: OBJECTIVE
  To investigate whether the parameters of machine perfusion could predict the quality of kidneys from donation after circulatory death (DCD) donors and expanded criteria donors (ECD).
  
  
  METHODS
  Fifty-eight kidneys from DCD/ECD donors were harvested in our hospital from July 2011 to August 2014. All kidneys were preserved with machine perfusion (Life Port), and parameters of machine perfusion were collected. All kidneys were biopsied before transplantation. The primary endpoints were delayed graft function (DGF), graft loss and patient death.
  
  
  RESULTS
  After kidney transplantation, 26 patients (44.8%) had DGF. We chose 1 h RI as a predictive parameter to predict DGF after transplant, and made the ROC curve. The ROC curve showed that 1 h RI = 0.4 was the best cut-off point for predicting DGF after transplant. The sensitivity was 61.54%, and the specificity was 81.25%. Fifty-eight recipients were divided into two groups according to 1 h RI of machine perfusion. 22 cases in high RI group (RI > 0.4) and 36 cases in low RI group (RI ≤0.4). DGF rate was significantly higher in the high RI group (72.7% vs. 27.8%). One year serum creatinine levels were also significantly higher in the high RI group (P < 0.05). Acute rejection rate and 1 year graft and patient survival were comparable.
  
  
  CONCLUSIONS
  One hour RI of machine perfusion is associated with DGF and 1 year graft function in DCD/ECD kidney transplantation, and may be a non-invasive tool for evaluating quality of DCD/ECD kidneys.
authors.affiliation: Organ Transplant Center, The First affiliated hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Guodong
authors.initials: G
authors.lastname: Chen
authors.affiliation: Organ Transplant Center, The First affiliated hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Wang
authors.affiliation: Zhongshan Medical School, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Zhongshan Medical School, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Longhui
authors.initials: L
authors.lastname: Qiu
authors.affiliation: Organ Transplant Center, The First affiliated hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Yuan
authors.affiliation: Organ Transplant Center, The First affiliated hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Qiu
authors.affiliation: Organ Transplant Center, The First affiliated hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Changxi
authors.initials: C
authors.lastname: Wang
authors.affiliation: Organ Transplant Center, The First affiliated hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: He
authors.affiliation: Organ Transplant Center, The First affiliated hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Lizhong
authors.initials: L
authors.lastname: Chen
mesh_terms: D000328:Adult; D001706:Biopsy; D002681:China; D051799:Delayed Graft Function / Q000209:etiology / Q000503:physiopathology; D046148:Donor Selection; D005260:Female; D006084:Graft Rejection / Q000209:etiology / Q000503:physiopathology; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D009392:Nephrectomy; D009926:Organ Preservation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010477:Perfusion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome