Evaluation of outcomes in renal transplantation with hypothermic machine perfusion for the preservation of kidneys from expanded criteria donors
| Autor: | Marie-Alice Macher, Olivier Bastien, Hélène Logerot, Corinne Antoine, Benoit Barrou, Marc Hazzan, Johnny Sayegh, Philippe Gatault, Dominique Bertrand, Imad Abboud, Emilie Savoye, Camille Legeai, Christian Lamotte, Olivier Huot, Antoine Thierry, Lionel Badet, Michel Videcoq, Sarah J. Drouin |
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| Rok vydání: | 2018 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty animal structures Health authority Urology Cold storage Delayed Graft Function 030230 surgery 03 medical and health sciences 0302 clinical medicine Hypothermia Induced Risk Factors medicine Humans Prospective Studies Aged Cryopreservation Transplantation Machine perfusion Kidney Kidney preservation Proportional hazards model business.industry Graft Survival Organ Preservation Middle Aged Prognosis Kidney Transplantation Tissue Donors Perfusion Survival Rate medicine.anatomical_structure Kidney Failure Chronic 030211 gastroenterology & hepatology Female business Follow-Up Studies |
| Zdroj: | Clinical transplantation. 33(5) |
| ISSN: | 1399-0012 |
| Popis: | In 2012, an expert working group from the French Transplant Health Authority recommended the use of hypothermic machine perfusion (HMP) to improve kidney preservation and transplant outcomes from expanded criteria donors, deceased after brain death. This study compares HMP and cold storage (CS) effects on delayed graft function (DGF) and transplant outcomes. We identified 4,316 kidney transplants from expanded criteria donors (2011-2014) in France through the French Transplant Registry. DGF occurrence was analyzed with a logistic regression, excluding preemptive transplants. One-year graft failure was analyzed with a Cox regression. A subpopulation of 66 paired kidneys was identified: one preserved by HMP and the other by CS from the same donor. Kidneys preserved by HMP (801) vs CS (3515) were associated with more frequent recipient comorbidities and older donors and recipients. HMP had a protective effect against DGF (24% in HMP group and 38% in CS group, OR = 0.49 [0.40-0.60]). Results were similar in the paired kidneys (OR = 0.23 [0.04-0.57]). HMP use decreased risk for 1-year graft failure (HR = 0.77 [0.60-0.99]). Initial hospital stays were shorter in the HMP group (P < 0.001). Our results confirm the reduction in DGF occurrence among expanded criteria donors kidneys preserved by HMP. |
| Databáze: | OpenAIRE |
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