Deceased-donor kidney perfusate and urine biomarkers for kidney allograft outcomes: a systematic review

Abstract

Higher quality studies are needed to investigate modern kidney injury biomarkers, to validate novel biomarkers in larger donor populations and to determine the incremental predictive value of biomarkers over traditional clinical variables.

Donor Hemodynamics as a Predictor of Outcomes After Kidney Transplantation From Donors After Cardiac Death

“…Further research is warranted to investigate associations between donor hemodynamic profiles and processes contributing to organ injury. Investigation of associations between renal perfusate biomarkers and donor hemodynamics is a logical direction for future research (26)(27)(28)(29). Although our findings indicate that certain parameters may be associated with inferior outcomes, it is unlikely that any one hemodynamic measure will be sufficient to describe relevant physiological changes (eg, donors with the same AUCSBP could have radically different SBP trajectories).…”

New Solutions to Reduce Discard of Kidneys Donated for Transplantation

“…18,19 A similar lack of validation limits the utility of pumping parameters or perfusate biomarker concentrations to predict graft outcomes for kidneys that undergo machine perfusion. 20 The lack of accurate methods to assess kidney quality probably explains some of the wide geographic variation in kidney discard rates (Figure 4). This variation suggests that organs considered too marginal in some regions would be transplanted in others.…”

Resistance Index Determination in the Pre and Post Kidney Transplantation Time Points in Graft Dysfunction Diagnosis

“…The Machine Preservation Trial has showed that HMP decreases the incidence of primary nonfunction (PNF) and delayed graft function (DGF), and increases 1-year graft survival compared with standard static cold storage [1,2]. In addition, HMP offers the unique possibility to assess the graft in the interval between procurement and transplantation by monitoring perfusion dynamics and/or perfusate biomarkers that may correlate with graft outcome [3,4]. There is evidence that perfusion parameters correlate with kidney graft function.…”