Functional Results of Renal Preservation in Hypothermic Pulsatile Machine Perfusion Versus Cold Preservation: Systematic Review and Meta-Analysis of Clinical Trials

Arcos, L. Martínez; Alcañiz, José Javier Fabuel; Santos, V. Gómez Dos; Revilla, F.J. Burgos

doi:10.1016/j.transproceed.2017.12.005

Cited by 21 publications

(21 citation statements)

References 44 publications

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“…[19][20][21][22] The difference in the definition of the primary endpoint consti- whereas a single dialysis did not (P = .93). [19][20][21][22] The difference in the definition of the primary endpoint consti- whereas a single dialysis did not (P = .93).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, in support of the MP method, several meta-analyses showed that MP reduces DGF of kidneys from all donor types, including DBD, DCD, and ECD. [19][20][21][22] The difference in the definition of the primary endpoint consti- whereas a single dialysis did not (P = .93). 12 It is very unlikely that the effect of dopamine pretreatment was arbitrarily overestimated by the use of a more specific surrogate endpoint of early graft dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Donor organ intervention before kidney transplantation: Head-to-head comparison of therapeutic hypothermia, machine perfusion, and donor dopamine pretreatment. What is the evidence?

Schnuelle

Drüschler

Schmitt

et al. 2019

American Journal of Transplantation

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Therapeutic hypothermia, hypothermic pulsatile machine perfusion (MP), and renaldose dopamine administered to stable brain-dead donors have shown efficacy to reduce the dialysis requirement after kidney transplantation. In a head-to-head comparison of the three major randomized controlled trials in this field, we estimated the number-needed-to-treat for each method, evaluated costs and inquired into special features regarding long-term outcomes. The MP and hypothermia trials used any dialysis requirement during the first postoperative week, whereas the dopamine trial assessed >1 dialysis session as primary endpoint. Compared to controls, the respective rates declined by 5.7% with MP, 10.9% with hypothermia, and 10.7% with dopamine. Costs to prevent one endpoint in one recipient amount to approximately $17 000 with MP but are negligible with the donor interventions. MP resulted in a borderline significant difference of 4% in 3-year graft survival, but a point of interest is that the preservation method was switched in 25 donors (4.6%) for technical reasons. Graft survival was not improved with dopamine on intention-to-treat but suggested an exposure-response relationship with infusion time. MP was less efficacious and cost-effective to prevent posttransplant dialysis. Whether the benefit on early graft dysfunction achieved with any method will improve long-term graft survival remains to be established. K E Y W O R D Sclinical research/practice, critical care/intensive care management, delayed graft function (DGF), donors and donation: deceased, kidney (allograft) function/dysfunction, organ perfusion and preservation, organ procurement and allocation, organ transplantation in general

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Donor organ intervention before kidney transplantation: Head-to-head comparison of therapeutic hypothermia, machine perfusion, and donor dopamine pretreatment. What is the evidence?

Schnuelle

Drüschler

Schmitt

et al. 2019

American Journal of Transplantation

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“…[18]. Two meta analyses have been performed comparing hypothermic machine perfusion to static cold storage [19,20]. Machine perfusion had short term benefits with decreased rate of DGF.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Outcome of Kidney Transplant After Pulsatile or Continuous Ex Vivo Hypothermic Machine Perfusion of Kidneys Donated After Cardiac Death: Analysis of Kidney Pairs

Sevinc

Stamp

Ling

et al. 2019

Transplantation Proceedings

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“…Because of the large number of perfusion systems and preclinical and clinical trials, we exemplarily discuss the potential of machine perfusion in the setting of liver perfusion in the following section. Various reviews and reports on perfusion systems for the heart , lung , kidney , and initial studies in pancreas and VCA are available elsewhere.…”

Section: Advances In Organ and Tissue Preservationmentioning

confidence: 99%

Emerging technologies in organ preservation, tissue engineering and regenerative medicine: a blessing or curse for transplantation?

et al. 2019

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Summary Since the beginning of transplant medicine in the 1950s, advances in surgical technique and immunosuppressive therapy have created the success story of modern organ transplantation. However, today more than ever, we are facing a huge discrepancy between organ supply and demand, limiting the potential for transplantation to save and improve the lives of millions. To address the current limitations and shortcomings, a variety of emerging new technologies focusing on either maximizing the availability of organs or on generating new organs and organ sources hold great potential to eventully overcoming these hurdles. These advances are mainly in the field of regenerative medicine and tissue engineering. This review gives an overview of this emerging field and its multiple sub‐disciplines and highlights recent advances and existing limitations for widespread clinical application and potential impact on the future of transplantation.

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Functional Results of Renal Preservation in Hypothermic Pulsatile Machine Perfusion Versus Cold Preservation: Systematic Review and Meta-Analysis of Clinical Trials

Cited by 21 publications

References 44 publications

Donor organ intervention before kidney transplantation: Head-to-head comparison of therapeutic hypothermia, machine perfusion, and donor dopamine pretreatment. What is the evidence?

Donor organ intervention before kidney transplantation: Head-to-head comparison of therapeutic hypothermia, machine perfusion, and donor dopamine pretreatment. What is the evidence?

Comparison of the Outcome of Kidney Transplant After Pulsatile or Continuous Ex Vivo Hypothermic Machine Perfusion of Kidneys Donated After Cardiac Death: Analysis of Kidney Pairs

Emerging technologies in organ preservation, tissue engineering and regenerative medicine: a blessing or curse for transplantation?

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