Cold machine perfusion versus static cold storage of kidneys donated after cardiac death: a UK multicenter randomized controlled trial.

Journal article

One third of deceased donor kidneys for transplantation in the UK are donated following cardiac death (DCD). Such kidneys have a high rate of delayed graft function (DGF) following transplantation. We conducted a multicenter, randomized controlled trial to determine whether kidney preservation using cold, pulsatile machine perfusion (MP) was superior to simple cold storage (CS) for DCD kidneys. One kidney from each DCD donor was randomly allocated to CS, the other to MP. A sequential trial design was used with the primary endpoint being DGF, defined as the necessity for dialysis within the first 7 days following transplant. The trial was stopped when data were available for 45 pairs of kidneys. There was no difference in the incidence of DGF between kidneys assigned to MP or CS (58% vs. 56%, respectively), in the context of an asystolic period of 15 min and median cold ischemic times of 13.9 h for MP and 14.3 h for CS kidneys. Renal function at 3 and 12 months was similar between groups, as was graft and patient survival. For kidneys from controlled DCD donors (with mean cold ischemic times around 14 h), MP offers no advantage over CS, which is cheaper and more straightforward.

Authors: Watson, C; Wells, A; Roberts, R; Akoh, J; Friend, P

• Publication status: Published
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
• Volume: 10
• Issue: 9
• Pages: 1991-1999
• Publication date: 2010-09-01
• DOI: 10.1111/j.1600-6143.2010.03165.x
• EISSN: 1600-6143
• ISSN: 1600-6135
• Language: English
• Keywords: Organ Preservation; Treatment Outcome; Female; Graft Rejection; Pulsatile Flow; Refrigeration; Perfusion; Delayed Graft Function; Postoperative Period; Death; Kidney Transplantation; Acute Disease; Incidence; Middle Aged; Cryopreservation; Tissue Donors; Adult; Humans; Male; Kidney