Systematic review and meta-analysis of hypothermic machine perfusion <i>versus</i> static cold storage of kidney allografts on transplant outcomes

O’Callaghan, John; Morgan, Robert D.; Knight, Simon R.; Morris, Peter J.

doi:10.1002/bjs.9169

Cited by 137 publications

(96 citation statements)

References 44 publications

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“…367 Moreover, recent RCTs have demonstrated a beneficial effect of hypothermic machine perfusion on kidneys from all donor types (donation after brain death, DCD, and donors with a high KDPI), by reducing the incidence of DGF. [368][369][370] Graft survival rates varied among the studies, but Moers et al 369 reported improved 1-year graft survival in the machineperfusion group. 368,369 A first single case report in humans performed by Hosgood et al in 2011 and a larger case series in 2013 demonstrated the feasibility of normothermic machine perfusion for the preservation of the kidney graft before transplantation.…”

Section: Prevention Of Early Ischemic Injury and Dgf In Kidney Transpmentioning

confidence: 99%

“…[368][369][370] Graft survival rates varied among the studies, but Moers et al 369 reported improved 1-year graft survival in the machineperfusion group. 368,369 A first single case report in humans performed by Hosgood et al in 2011 and a larger case series in 2013 demonstrated the feasibility of normothermic machine perfusion for the preservation of the kidney graft before transplantation. Indeed, normothermic machine perfusion may have the advantage of maintaining cellular metabolism compared with hypothermic machine perfusion and allow monitoring of viability, with the potential to increase the efficacy of drugs administered before transplantation.…”

Section: Prevention Of Early Ischemic Injury and Dgf In Kidney Transpmentioning

confidence: 99%

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Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

et al. 2017

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Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes. COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant. The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting. 12 Department of Gastroenterology and Hepatology, Erasmus MC, University Hospital Rotterdam, the Netherlands. 13 Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium.14 Abdominal Transplant Surgery, Microbiology and Immunology Department, University Hospitals KU Leuven, Belgium. 15 Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Spain. www.transplantjournal.com S1 S olid organ transplantation has evolved from an experimental procedure to an established treatment option for many types of end-stage organ failure. Both patient and graft outcomes are continuing to improve, and 1-year patient and graft survival currently exceed 80%.1,2 However, survival rates gradually decline over the long term. In kidney transplant, 5-and 10-year graft survival rates in Europe are 77% and 56%, and for liver transplant, 64% and 54% (Figures 1 and 2). 3,4 Although most European countries have seen an increase in both living and deceased donation, transplantation is not available to all who would benefit from the procedure, and there is considerable morbidity and mortality for those listed for transplant.6 Therefore, maximizing long-term graft survival and reducing the need for retransplantation is paramount, not only in improving outcomes for the recipients but also for those awaiting a graft. The improvement in outcomes is predominantly due to reduction in (Transplantation. 2017;101:S1-S41). The authors were approached by Astellas to discuss the practical implementation o...

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Section: Prevention Of Early Ischemic Injury and Dgf In Kidney Transpmentioning

confidence: 99%

Section: Prevention Of Early Ischemic Injury and Dgf In Kidney Transpmentioning

confidence: 99%

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

et al. 2017

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“…Hypothermic machine perfusion (HMP) is used with the intention to limit the occurrence of DGF and ameliorate allograft function in comparison with static cold storage (40)(41)(42). Through the continuous perfusion of the kidney with a cold preservation solution, is able to remove toxic metabolites, decrease lactic acid production and provide nutrients from the kidney.…”

Section: Perfusate Biomarkersmentioning

confidence: 99%

Pre-transplant biomarkers and prediction of post-transplant outcomes in kidney transplantation

Salvadori¹,

Tsalouchos²

2017

J Renal Inj Prev

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New findings in "omics" and genomics allowed us to find out new robust biomarkers that may allow a diagnosis avoiding invasive and dangerous procedures. This could be of particular importance if applied on transplant clinical practice. In kidney transplantation several pre-transplant biomarkers revealed useful either for a better renal allocation and as predictive of future outcomes as delayed graft function, rejections and long term outcome. Different biomarkers have been recently described bringing interesting results regarding predictive outcomes in the field of kidney transplantation. In this setting, an evaluation for pre-transplant biomarkers especially in the era of expanded criteria donors (ECDs) and non-heart-beating donors (NHBDs) could help transplant physicians to make decisions on allocation or even on discharge of the allograft. Furthermore, identify pre-transplant biomarkers is useful for a risk stratification of delayed graft function (DGF), acute rejection (AR) episodes and chronic allograft dysfunction (CAD) after kidney transplantation (KT). In this review, we report recent findings on pre-transplant biomarkers from various biological samples from donors or recipients. Please cite this paper as:

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“…Although more updated cost-effectiveness analysis are still needed [13], current trends seem to support the use of HMP for DBD kidneys [14], especially from marginal donors [15]. Indeed, kidneys preserved on HMP show lower rates of DGF compared to cold storage and it is well recognized that DBD and ECD transplants experiencing DGF do have an increased risk of acute rejection, poor graft function, and graft failure [16].…”

Section: Journal Of Transplantation Technologies and Research Respectivmentioning

confidence: 99%

Hypothermic Machine Perfusion in Kidney Transplantation: Back to the Future?

Ferraresso¹,

Favi²

2015

J Transplant Technol Res

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Static cold storage is currently the most used method of organ preservation worldwide. However, cutting edge technology and dramatic changes in the donor pattern have lately renewed the interest toward hypothermic machine perfusion. Marginal and cardiac death donors show higher rates of primary non function and delayed graft function compared to standard criteria donors. In this setting, machine perfusion may offer several theoretical advantages such as improved organ preservation, continuous graft evaluation, and ex-vivo conditioning of the graft before implantation. These topics have been recently reassessed by several studies. In particular, perfusion characteristics (renal resistance) and perfusate biomarker concentrations (lactate dehydrogenase, aspartate aminotransferase, heart-type fatty acid binding protein, and IL-18) during machine preservation, proved to be reliable tools to rule out graft viability and predict outcomes after transplantation. Treatment strategies acting on tissue repair, cell metabolism, and allorecognition pathway are also under investigation with promising results. Machine perfusion has finally shown its real potential however, stronger evidences and updated cost-effectiveness analysis are needed to fully support its role for the next future.

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Systematic review and meta-analysis of hypothermic machine perfusion versus static cold storage of kidney allografts on transplant outcomes

Cited by 137 publications

References 44 publications

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

Pre-transplant biomarkers and prediction of post-transplant outcomes in kidney transplantation

Hypothermic Machine Perfusion in Kidney Transplantation: Back to the Future?

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