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Made available in DSpace on 2018-11-26T17:34:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-06-01
Background. This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). Methods. In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF. Secondary endpoints included the duration of DGF, hospital stay, primary nonfunction, estimated glomerular filtration rate, acute rejection, and allograft and patient survivals. Results. Mean cold ischemia time was high but not different between the 2 groups (25.6 +/- 6.6 hours vs 25.05 +/- 6.3 hours, 0.937). The incidence of DGF was lower in the machine perfusion compared with cold storage group (61% vs. 45%, P = 0.031). Machine perfusion was independently associated with a reduced risk of DGF (odds ratio, 0.49; 95% confidence interval, 0.26-0.95). Mean estimated glomerular filtration rate tended to be higher at day 28 (40.6 +/- 19.9 mL/min per 1.73 m(2) vs 49.0 +/- 26.9 mL/min per 1.73 m(2); P = 0.262) and 1 year (48.3 +/- 19.8 mL/min per 1.73 m(2) vs 54.4 +/- 28.6 mL/min per 1.73 m(2); P = 0.201) in the machine perfusion group. No differences in the incidence of acute rejection, primary nonfunction (0% vs 2.5%), graft loss (7.5% vs 10%), or death (8.8% vs 6.3%) were observed. Conclusions. In this cohort of recipients of deceased donor kidneys with high mean cold ischemia time and high incidence of DGF, the use of continuous machine perfusion was associated with a reduced risk of DGF compared with the traditional cold storage preservation method.
Univ Fed Sao Paulo, Hosp Rim, Sao Paulo, SP, Brazil
Escola Paulista Med, Org Procura Orgaos, Sao Paulo, SP, Brazil
Univ Sao Paulo, Fac Med, Hosp Clin, Sao Paulo, SP, Brazil
Hosp Israelita Albert Einstein, Kidney Transplant Unit, Sao Paulo, SP, Brazil
Hosp Samaritano, Sao Paulo, SP, Brazil
Santa Casa Sao Paulo, Sao Paulo, SP, Brazil
Hosp Bandeirantes, Sao Paulo, SP, Brazil
Hosp Servidor Publ Estadual, Sao Paulo, SP, Brazil
Hosp Beneficencia Portuguesa, Sao Paulo, SP, Brazil
Hosp Dante Pazzanese, Sao Paulo, SP, Brazil
Hosp Base Sao Jose do Rio Preto, Sao Jose Do Rio Preto, SP, Brazil
Univ Estadual Paulista, UNESP, Dept Internal Med, Rubiao Jr S-N, Sao Paulo, Brazil
Santa Casa Ribeirao Preto, Ribeirao Preto, SP, Brazil
Hosp Alemao Oswaldo Cruz, Sao Paulo, SP, Brazil
Hosp Santa Marcelina, Sao Paulo, SP, Brazil
Univ Estadual Paulista, UNESP, Dept Internal Med, Rubiao Jr S-N, Sao Paulo, Brazil
