Author(s): de Sandes-Freitas, Tainá Veras ; Costa, Silvana Daher ; de Andrade, Luís Gustavo Modelli [UNESP] ; Girão, Celi Melo ; Fernandes, Paula Frassinetti C.B.C. ; Costa de Oliveira, Claudia Maria ; Esmeraldo, Ronaldo de Matos
Date: 2021
Persistent ID: http://hdl.handle.net/11449/205647
Origin: Oasisbr
Subject(s): MeSH Delayed Graft Function; Organ Preservation; Pulsatile Flow
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Background: Material/Methods: Results: Conclusions: The present study analyzed the impact of hypothermic pulsatile machine perfusion (MP) following a long period of static cold (SC) storage in the peculiar Brazilian scenario of high incidence of delayed graft function (DGF), despite good donor characteristics. A retrospective analysis, with a 1-year follow-up, of 206 recipients of donor-matched paired kidneys was per-formed. Of the 206 donor kidneys, 103 were maintained exclusively in static cold storage (SC group) and 103 were kept on machine perfusion after a period of SC preservation (MP group). All donors were brain dead. Only 4.9% of the kidneys were from expanded-criteria donors. Static cold ischemia time (CIT) in the SC group was 20.8±4.1 hours vs. 15.8±6.2 hours in the MP group (P<0.001). Dynamic CIT in the MP group was 12.3±5.7 hours. MP significantly reduced DGF incidence (29.1% vs. 55.3%, P<0.001), and this effect was confirmed in multivariable analysis (OR, 1.115; 95% CI, 1.033–1.204, P=0.001). No differences were observed between the groups with regard to DGF duration, length of hospital stay, incidence of primary nonfunction and acute rejec-tion, graft loss, death, or renal function. In this Brazilian setting, MP following a long period of SC preservation was associated with reduced DGF incidence in comparison with SC storage without MP.
Department of Clinical Medicine Faculty of Medicine Federal University of Ceará
Transplant Division Hospital Geral de Fortaleza
Department of Internal Medicine Paulista State University - UNESP
Transplant Division Walter Cantídio University Hospital
Department of Internal Medicine Paulista State University - UNESP
