Meta-Analysis and Clinical Guidance of Oxygenated Hypothermic Machine Perfusion for Kidney Transplantation

It remains unclear whether oxygenated hypothermic machine perfusion (HMPO₂) during kidney preservation is beneficial for prognosis.

A comprehensive search of databases and clinical trial registries was conducted to identify eligible studies on HMPO₂ application during kidney transplantation. A multisubgroup analysis was further conducted to explore the heterogeneity among studies.

Compared to the control treatment, HMPO₂ did not significantly alter the incidence of postoperative acute rejection, graft survival, patient mortality, delayed graft function (DGF), functional DGF, primary nonfunction, or estimated glomerular filtration rate, whereas the warm ischemia time appeared to be longer. However, the number of patients with adverse events and the proportion of severe adverse events were reduced in the HMPO₂ group. Subgroup analysis indicated that HMPO₂ performed better in donation after cardiac death (DCD), and continuous HMPO₂ was superior to end-HMPO₂.

HMPO₂ application during kidney transplantation reduced the number of patients with adverse events and the proportion of severe adverse events. However, given the issue such as limited number of studies and heterogeneity, rigorous evidence studies are needed to further confirm these findings.