One-year results of a prospective, randomized, trial comparing two machine perfusion devices used for kidney preservation

Transplant International One-year results of a prospective, randomized, trial comparing two machine perfusion devices used for kidney preservation

Studies have shown beneficial effects of machine perfusion (MP) on early kidney function and long-term graft survival. The aim of this study was to investigate whether the type of perfusion device could affect outcome of transplantation of deceased donor kidneys. A total of 50 kidneys retrieved from 25 donors were randomized to machine perfusion using a flow driven (FD) device (RM3; Waters Medical Inc) or a pressure driven (PD) device (LifePort; Organ Recovery Systems), 24 of these kidneys (n=12 pairs; 48%) were procured from expanded criteria donors (ECD). The primary endpoints were kidney function after transplantation defined using the incidence of delayed graft function (DGF), the number of hemodialysis sessions required, graft function at 12 months, and analyses of biopsy. DGF was similar in both groups (32%; 8/25). Patients with DGF in the FD group required a mean of 4.66 hemodialysis sessions versus 2.65 in the PD group (p=0.005). Overall 1-year graft survival was 80% (20/25) versus 96% (24/25) in the FD and PD groups. One-year graft survival of ECD kidneys was 66% (8/12) in the FD group versus 92% (11/12) in the PD group. Interstitial fibrosis and tubular atrophy were significantly more common in the FD group – 45% (5/11) versus 0% (0/9) (p=0.03) in PD group. There were no differences in creatinine levels between the groups.Machine perfusion using a pressure driven device generating lower pulse stress is superior to a flow driven device with higher pulse stress for preserving kidney function. This article is protected by copyright. All rights reserved.


http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Ftri.12169

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