Machine perfusion preservation improves renal allograft survival

Area of Science:

• Nephrology
• Transplantation Surgery
• Organ Preservation

Background:

• Machine perfusion (MP) has been utilized for kidney preservation for over a decade.
• Previous small studies indicated a higher incidence of delayed graft function with cold storage (CS).
• Limited literature exists on the long-term impact of storage modality on renal allograft function.

Purpose of the Study:

• To analyze the long-term outcomes of renal transplantation comparing machine perfusion (MP) and cold storage (CS) preservation methods.
• To evaluate the effect of storage modality on graft survival and return to dialysis.

Main Methods:

• A retrospective analysis of 415 renal transplant recipients between 1994 and 1999.
• Comparison of 227 MP-preserved kidneys versus 188 CS-preserved kidneys.
• Data collected included donor demographics, medical data, cold ischemia time, HLA match, and recipient data; standard immunosuppression was used.

Main Results:

• Despite longer cold ischemia times and poorer donor hemodynamics in the MP group, 5-year Kaplan-Meier graft survival was significantly better for MP-stored kidneys (68.2%) compared to CS-stored kidneys (54.2%, p = 0.02).
• The study observed improved graft survival and a reduced incidence of return to hemodialysis in the MP group.

Conclusions:

• Kidney storage using machine perfusion (MP) demonstrated improved long-term graft survival in renal transplantation.
• MP kidney preservation was associated with a lower rate of return to dialysis compared to cold storage (CS).