American Journal of Transplantation
American Journal of Transplantation
5 years ago

Outcomes of Donation after Circulatory Death kidneys undergoing Hypothermic Machine Perfusion following Static Cold Storage: A UK population-based cohort study

James Hodson, Andrew Ready, Kamlesh Patel, Nick Inston, Jay Nath
Evidence is currently lacking regarding the outcomes of kidneys undergoing Hypothermic Machine Perfusion (HMP) in the UK. Using the National Health Service Blood and Transplant database, the authors compared outcomes for recipients of single organ Donation after Circulatory Death (DCD) kidneys preserved with HMP to those using only static cold storage (SCS). Between 2007 and 2015, HMP was used in 19.1% (864/4,529) of kidneys. Rates of delayed graft function (DGF) were significantly lower in organs preserved with HMP than for SCS (34.2% vs. 42.0%, p<0.001), despite a slightly longer cold ischaemic time (median: 14.8 vs. 14.1hrs, p<0.001). Multivariable analysis found the effect of preservation modality to remain significant, with HMP organs having a significantly lower rate of DGF (Odd ratio 0.65, 95% CI: 0.53–0.80, p<0.001), and significantly shorter times to DGF resolution (average: 6.1 vs. 7.4 days, p=0.003) than SCS organs. Both patient (p=0.313) and graft (p=0.263) survival rates were similar in the two preservation groups. HMP was associated with a marginal functional benefit in 1 year creatinine values (p=0.044), with adjusted averages of 1.36mg/dL (HMP) vs 1.40mg/dL (SCS). This study supports the use of HMP and aids decision making over its instigation, which may improve short-term patient outcomes. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/ajt.14587

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.