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Hypothermic machine perfusion improves D oppler ultrasonography resistive indices and long‐term allograft function after renal transplantation: a single‐centre analysis
Author(s) -
Dion Marie S.,
McGregor Thomas B.,
McAlister Vivian C.,
Luke Patrick P.,
Sener Alp
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12960
Subject(s) - machine perfusion , transplantation , kidney transplantation , renal function , medicine , kidney , population , urology , perfusion , cold storage , surgery , cardiology , biology , environmental health , horticulture , liver transplantation
Objectives To evaluate whether hypothermic machine perfusion ( HMP ) of transplanted kidneys can improve long‐term renal allograft function compared with static cold storage ( CS ). Methods We evaluated whether graft D oppler ultrasonography resistive indices improved with the use of HMP compared with CS preservation, and examined whether these improvements were predictive of long‐term graft function. A total of 30 kidney transplants (15 pairs) were examined. One of the kidney pairs was placed on CS and transplanted first ( CS group, n = 15). The other kidney of each pair was placed on HMP and transplanted after the CS group ( HMP group, n = 15). D oppler ultrasonography was performed on days 1 and 7 after transplantation and resistive indices were evaluated. The estimated glomerular filtration rate ( eGFR ) was monitored for 24 months after transplantation. Results Despite longer cold ischaemia times, kidneys maintained with HMP had lower resistive indices ( P = 0.005) with correspondingly higher eGFR throughout the follow‐up. Subgroup analysis showed that the HMP ‐induced improvement in postoperative eGFR was greatest in kidneys obtained from donation after cardiac death ( DCD ), even at 2 years after transplantation ( P = 0.008). Conclusions HMP of transplant kidneys appears to improve vascular resistance after transplantation and has a positive impact on long‐term allograft function compared with CS in the population of recipients of DCD kidneys.