Transplant Trial Watch

Outcome Improvement for Hypothermic Machine Perfusion Versus Cold Storage for Kidneys From Cardiac Death Donors.

Zhong Z, Lan J, et al.

Artificial Organs 2017; 41(7): 647-653.


Aims
To compare the effect of machine perfusion (MP) and cold storage (CS) in protecting kidneys harvested from cardiac death donors (DCDs).

Interventions
One kidney from each donor was randomly assigned to MP and the contralateral kidney was assigned to CS.

Participants
282 kidneys from 141 donors were included in the study. All donors were Maastricht category III (awaiting cardio circulatory death after withdrawal of treatment) and aged ≥ 16 years old. Recipients were those undergoing their first kidney transplant and not receieving multiple organs.

Outcomes
Measured outcomes included delayed graft function (DGF), functional DGF, resistance index of renal arteries, early renal function, and graft survival rates.

Follow-up
3 years

CET Conclusions
This study used kidney pairs from the same donor, one allocated to each of hypothermic machine perfusion (HMP) and static cold storage. The study found that DGF rates were decreased from 33% to 22% using HMP, which is consistent with other published studies. The stand out result was that the 1-year and 3-year graft survival was also improved by HMP (98% v 93% and 93% v 82%), which is at odds with some other recent studies. Renal resistance on post -operative ultrasound scan was improved by HMP. Donors were all Maastricht category III. Perfusion parameters were not used in decision making regarding transplantation.

Jadad score
2

Data analysis
Modified intention-to-treat analysis

Alocation concealment
No

Trial registration
None

Funding source
Non-industry funded