Cold Pulsatile Machine Perfusion versus Static Cold Storage in Kidney Transplantation: A Single Centre Experience.

Area of Science:

• Nephrology
• Transplant Surgery
• Organ Preservation

Background:

• Kidney transplantation outcomes are influenced by preservation methods.
• Hypothermic machine perfusion (HMP) and cold storage (CS) are common kidney preservation techniques.
• Comparing HMP and CS is crucial for optimizing transplant success.

Purpose of the Study:

• To compare kidney transplant outcomes between hypothermic machine perfusion (HMP) and cold storage (CS).
• To evaluate the impact of HMP on delayed graft function (DGF), hospital stay, graft function, and survival.
• To analyze Renal Resistive Indexes (RIs) during HMP for predicting DGF.

Main Methods:

• Retrospective analysis of 33 HMP and 33 CS kidney transplants.
• Comparison of delayed graft function (DGF), length of hospital stay (LOS), estimated glomerular filtration rate (eGFR), and patient/graft survival.
• Analysis of Renal Resistive Indexes (RIs) during HMP in relation to DGF.

Main Results:

• HMP group showed lower DGF (p=0.041) and higher 365-day eGFR (p<0.001) versus CS.
• Donation after Circulatory Death (DCD) predicted DGF; HMP reduced DGF in DCD grafts (p=0.036).
• RIs during HMP predicted DGF in both DCD and Donation after Brain Death (DBD) kidneys with high accuracy.

Conclusions:

• HMP significantly decreases DGF compared to CS in kidney transplantation.
• HMP provides pre-transplant viability assessment and improves one-year renal function.
• HMP is a promising technique for enhancing kidney transplant outcomes.