Open AccessEarly experience with hypothermic machine perfusion of living donor kidneys – a retrospective study
Author(s) -
Moser Michael A. J.,
Ginther Nathan,
Luo Yigang,
Beck Gavin,
Ginther Ronn,
Ewen Marla,
MatscheNeufeld Rhianna,
Shoker Ahmed,
Sawicki Grzegorz
Publication year - 2017
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12964
Subject(s) - machine perfusion , medicine , renal function , perfusion , creatinine , urology , kidney , kidney transplantation , anesthesia , transplantation , surgery , liver transplantation
Summary Although hypothermic machine perfusion ( HMP ) has been shown to be beneficial to deceased donor kidneys, the effect of HMP on living donor kidneys ( LDK ) is unknown. LDK are subjected to minutes of normothermic ischemia at the time of recovery. Comparison of 16 LDK preserved by HMP with 16 LDK preserved by static cold storage ( SCS ). Outcomes of interest are resistive indices ( RI ), both while on HMP and postoperatively, and creatinine clearance (CrCl). Injury markers NGAL and LDH were seen in the perfusate of LDK in amounts similar to what is found for donation after neurological determination of death kidneys. Compared to SCS kidneys, CrCl was significantly higher in the HMP group from days 2 through 7 post‐transplant [ie: day 7 (78.8 ± 5.4 vs. 54.0 ± 4.6 ml/min, P = 0.005)]. CrCl at 1 year was higher in the HMP group (81.2 ± 5.8 vs. 70.0 ± 5.3 ml/min, P = 0.03). Early post‐transplant RI was significantly lower in the HMP group (0.61 ± 0.02 vs. 0.71 ± 0.02, P < 0.0001). Our data support the assertion that injury does occur during LDK procurement and suggest that some of this injury may be reversed with HMP , resulting in more favorable early RI and graft function compared to SCS kidneys.