Pulsatile machine perfusion with Vasosol solution improves early graft function after cadaveric renal transplantation

Area of Science:

• Nephrology
• Transplantation Immunology
• Surgical Innovation

Background:

• Cold storage is standard for renal allograft preservation, but pulsatile machine perfusion (MP) offers ex vivo assessment and resuscitation.
• High-risk renal allografts benefit from advanced preservation techniques.
• Vasosol (VSL) is a novel machine perfusion solution with enhanced vasodilatory and antioxidant properties.

Purpose of the Study:

• To evaluate the efficacy of Vasosol (VSL) machine perfusion solution in preserving renal allografts.
• To compare VSL with a standard control solution (Belzer MPS) in a randomized trial.
• To assess the impact of VSL on early graft function and post-transplant outcomes.

Main Methods:

• A randomized trial comparing VSL and Belzer MPS for machine preservation of 162 cadaveric kidney pairs.
• En bloc perfusion was performed using standard MP procedures.
• Prospective collection of donor, recipient, and graft outcome data from 12 transplant centers.

Main Results:

• VSL perfusion resulted in significantly higher rates of immediate graft function (p<0.05).
• Delayed graft function was significantly reduced in the VSL group (12.2% vs. 21.2%, p<0.05).
• VSL improved discharge creatinine levels and shortened hospital length of stay compared to the control group.

Conclusions:

• Vasosol (VSL) machine perfusion solution enhances early graft function and reduces length of stay post-renal transplantation.
• Improved preservation solutions combined with pulsatile perfusion hold promise for better renal transplant outcomes.
• VSL is particularly beneficial for extended criteria donor kidneys, improving early graft performance.