Does the Pulsatile Preservation Machine Have Any Impact in the Discard Rate of Kidneys From Older Donors After Brain Death?

Paredes-Zapata, David; Ruiz-Arranz, Angel; Rodríguez‐Villar, C.; Roque-Arda, R.; Peri-Cusi, L.; Saavedra-Escobar, S.; Vizcaino-Elias, F.; Garcia-Rodriguez, X.; Bohils-Valle, M.; Rodriguez-Peña, S.; Quijada-Martorell, M.; Gonzalez-Rodriguez, J.-J.; Oppenheimer-Salinas, F.; Alcaraz, Antonio; Adalia-Bartolome, R.

doi:10.1016/j.transproceed.2015.08.036

Cited by 8 publications

(10 citation statements)

References 15 publications

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“…Their contralateral counterpart preserved by eHMP had all been transplanted with primary kidney function and all recipients being free from dialysis at 12 months postoperative. This is in accordance with the findings of Poredes‐Zapato et al . where the use of pulsatile HMP was associated with a decrease in discard rates of kidneys from donors older than 60 years by more than 20%.…”

Section: Discussionsupporting

confidence: 81%

“…The aim of this observational study was to provide clinical data evaluat- This is in accordance with the findings of Poredes-Zapato et al 8 where the use of pulsatile HMP was associated with a decrease in discard rates of kidneys from donors older than 60 years by more than 20%.…”

Section: Discussionsupporting

confidence: 73%

“…Therefore, improved preservation by continuous HMP has the potential to reduce the well‐known disadvantages of ECD kidneys: higher rates of DGF, primary non‐function (PNF) and impaired long‐term graft survival . The application of continuous HMP may contribute to increase the utilization of ECD kidneys …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] The application of continuous HMP may contribute to increase the utilization of ECD kidneys. 8 Continuous HMP applied during the entire cold ischemia time (CIT) on a routine basis in ECD kidneys has meanwhile been introduced in a considerable number of European transplant centers, eg, in France, Switzerland, and the Netherlands. Its usage remains, however, controversial in others.…”

Section: Introductionmentioning

confidence: 99%

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Reconditioning by end‐ischemic hypothermic in‐house machine perfusion: A promising strategy to improve outcome in expanded criteria donors kidney transplantation

Gallinat

Amrillaeva

Hoyer

et al. 2017

Clinical Transplantation

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This clinical study evaluates end-ischemic hypothermic machine perfusion (eHMP) in expanded criteria donors (ECD) kidneys. eHMP was initiated upon arrival of the kidney in our center and continued until transplantation. Between 11/2011 and 8/2014 eHMP was performed in 66 ECD kidneys for 369 (98-912) minutes after 863 (364-1567) minutes of cold storage (CS). In 49 of 66 cases, the contralateral kidney from the same donor was preserved by static CS only and accepted by another Eurotransplant (ET) center. Five (10.2%) of these kidneys were ultimately judged as "not transplantable" by the accepting center and discarded. After exclusion of early unrelated graft losses, 43 kidney pairs from the same donor were eligible for direct comparison of eHMP vs CS only: primary non-function and delayed graft function (DGF) were 0% vs 9.3% (P=.04) and 11.6% vs 20.9% (P=.24). There was no statistically significant difference in 1-year graft survival (eHMP vs CS only: 97.7% vs 88.4%, P=.089). In a multivariate analysis, eHMP was an independent factor for prevention of DGF (OR: 0.28, P=.041). Development of DGF was the strongest risk factor for 1-year graft failure (Renal resistance: 38.2, P<.001). In summary, eHMP is a promising reconditioning technique to improve the quality and acceptance rate of suboptimal grafts.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reconditioning by end‐ischemic hypothermic in‐house machine perfusion: A promising strategy to improve outcome in expanded criteria donors kidney transplantation

Gallinat

Amrillaeva

Hoyer

et al. 2017

Clinical Transplantation

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“…Compared with SCS, HMP is complicated and costly. At the same time, HMP can reduce the renal discard rate (34,35). A systematic review showed that the costs may be completely defrayed by reduced requirement for hospital stay and dialysis associated with a reduced incidence of DGF and improved graft survival (33).…”

Section: Discussionmentioning

confidence: 99%

Hypothermic Machine Perfusion Versus Static Cold Storage in Deceased Donor Kidney Transplantation: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Peng

Ding

et al. 2018

Artificial Organs

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Static cold storage (SCS) and hypothermic machine perfusion (HMP) are two primary options for renal allograft preservation. Compared with SCS, HMP decreased the incidence of delayed graft function (DGF) and protected graft function. However, more evidence is still needed to prove the advantages of the HMP. In this study, the outcomes of kidney grafts from the two preservation methods were compared by conducting a systematic review and meta-analysis. Randomized controlled trials (RCTs) comparing the effect of hypothermic machine perfusion and static cold storage in deceased donor kidney transplantation were identified through searches of the MEDLINE, EMBASE, and Cochrane databases between January 1, 1980 and December 30, 2017. The primary endpoints were delayed graft function and graft survival. Secondary endpoints included primary non-function (PNF), graft renal function, duration of DGF, acute rejection, postoperative hospital stay and patient survival. Summary effects were calculated as risk ratio (RR) with 95% confidence interval (CI) or mean difference (MD) with 95% confidence intervals (CI). A total of 13 RCTs were included, including 2048 kidney transplant recipients. The results indicated that compared with SCS, HMP decreased the incidence of DGF (RR 0.78, 95% CI 0.69-0.87, P < 0.0001), and improved the graft survival at 3 years (RR 1.06, 95% CI 1.02-1.11, P = 0.009). There was no significant difference in other endpoints. HMP might be a more desirable method of preservation for kidney grafts. The long-term outcomes of kidney allografts stored by hypothermic machine perfusion still need to be further investigated.

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Pulsate Perfusion of Allografts

Tozzi

Piffaretti

Franchin

et al. 2019

Visceral Vessels and Aortic Repair

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Does the Pulsatile Preservation Machine Have Any Impact in the Discard Rate of Kidneys From Older Donors After Brain Death?

Cited by 8 publications

References 15 publications

Reconditioning by end‐ischemic hypothermic in‐house machine perfusion: A promising strategy to improve outcome in expanded criteria donors kidney transplantation

Reconditioning by end‐ischemic hypothermic in‐house machine perfusion: A promising strategy to improve outcome in expanded criteria donors kidney transplantation

Hypothermic Machine Perfusion Versus Static Cold Storage in Deceased Donor Kidney Transplantation: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Pulsate Perfusion of Allografts

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