Improved immediate function of renal allografts with Belzer perfusate

Area of Science:

• Nephrology
• Transplantation immunology
• Organ preservation

Background:

• Cadaveric kidney preservation is crucial for successful transplantation.
• Optimizing perfusates can enhance immediate graft function and long-term outcomes.
• Previous methods using silica gel perfusate had limitations in improving immediate function.

Purpose of the Study:

• To evaluate the efficacy of Belzer perfusate in machine perfusion of cadaveric kidneys.
• To compare the incidence of immediate kidney function using Belzer perfusate versus silica gel.
• To assess the impact of Belzer perfusate on post-transplant kidney function and its role in rescuing cold-stored kidneys.

Main Methods:

• Evaluation of 254 cadaveric kidneys.
• Primary machine perfusion with Belzer perfusate (n=140).
• Secondary perfusion with Belzer perfusate for previously cold-stored kidneys (n=14).
• Comparison with a historical group machine-perfused with silica gel.
• Analysis of perfusion characteristics and post-transplant function (serum creatinine clearance).

Main Results:

• Statistically significant improvement in immediate function with Belzer perfusate compared to silica gel.
• 100% immediate function in the secondary Belzer group (previously cold-stored kidneys).
• Improved parenchymal function post-transplant, evidenced by faster serum creatinine clearance.
• Increased machine resistance correlated with early graft dysfunction, allowing for predictive potential.

Conclusions:

• Belzer perfusate enhances immediate function in machine-perfused kidneys due to its metabolic substrates.
• It improves qualitative post-transplant kidney function.
• Belzer perfusate is effective as a rescue strategy for ATP-depleted, cold-stored kidneys.