Early function of kidneys stored by continuous hypothermic pulsatile perfusion can be predicted using a new “viability index”

Kosieradzki, Maciej; Danielewicz, R.; Kwiatkowski, A.; Polak, W.; Wszoła, Michał; Fesołowicz, S; Michalak, Grzegorz; Lisik, Wojciech; Wegrowicz-Rebandel, Irena; Pączek, Leszek; Wałaszewski, J; Rowińskí, W

doi:10.1016/s0041-1345(01)02838-x

Cited by 21 publications

(14 citation statements)

References 4 publications

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“…Significant associations between perfusate lactate levels and DGF were found in two of five studies that analyzed their relationship. The most recent study of perfusate lactate reported a sensitivity of 60.6% and specificity of 68.6% for detecting DGF [38]. This study was of 'fair' quality, while the other study reporting a significant association was of 'poor' quality.…”

Section: Perfusate Biomarker Performancementioning

confidence: 70%

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

Bhangoo¹,

Hall²,

Reese³

et al. 2012

Nephrology Dialysis Transplantation

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Section: Perfusate Biomarker Performancementioning

confidence: 70%

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

Bhangoo¹,

Hall²,

Reese³

et al. 2012

Nephrology Dialysis Transplantation

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“…Depending on the results of monitored parameters, relaxing agents (papaverine, verapamil) were administered to reduce resistance, bicarbonate and CO 2 insufflation to correct pH, and mannitol in cases of low osmolarity. Results of perfusion parameter analysis were published previously (18)(19). …”

Section: Kidney Preservationmentioning

confidence: 99%

“…Thus, it is possible to reduce the risk to allogenic kidney graft recipients by discarding kidneys which will not function when transplanted. MP is also thought to reduce the risk of donor-recipient HCV transmission (19)(20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Machine Perfusion Preservation Improves Renal Allograft Survival

Kwiatkowski

Wszoła

Kosieradzki

et al. 2007

American Journal of Transplantation

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Machine perfusion (MP) has been used as the kidney preservation method in our center for over 10 years. The first, small (n = 74) prospective, single-blinded randomized study comparing MP and Cold Storage (CS) showed that the incidence of delayed graft function was higher after CS. There have been no reports in the literature on the effect of storage modality on longterm function of renal allografts. This paper presents an analysis of long-term results of renal transplantation in 415 patients operated on between 1994 and 1999. Of those, 227 kidneys were MP-stored prior to KTx. The control group consisted of 188 CS kidney transplants. Kidneys were not randomized to MP or to CS. Donor demographics, medical and biochemical data, cold ischemia time, HLA match and recipient data were collected. Standard triple-drug immunosuppression was administered to both groups. Mortality, graft survival and incidence of return to hemodialysis treatment were analyzed. Despite longer cold ischemia time and poorer donor hemodynamics in MP group, 5-year Kaplan-Meier graft survival was better in MP-stored than in CS-stored kidneys (68.2% vs. 54.2%, p = 0.02). Conclusion: In this nonrandomized analysis, kidney storage by MP improved graft survival and reduced the number of patients who returned to dialysis.

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“…There has been a considerable amount of literature describing the use of pulsatile perfusion (PP) and testing the efficacy of this method of storage dating back 30 years (1-3). There have been numerous controlled trials and observa-tional studies examining storage techniques with regard to the impact of preservation methods on delayed graft function (DGF), acute rejection, renal function and graft survival (4)(5)(6)(7)(8)(9)(10)(11). Studies have examined outcomes in lieu of changes in immunosuppressive developments (12), the appropriate selection of organs applicable for PP (13)(14)(15)(16), the cost-effectiveness of storage techniques (17) and the impact of particular perfusates (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Are We Frozen in Time? Analysis of the Utilization and Efficacy of Pulsatile Perfusion in Renal Transplantation

Schold

Kaplan

Howard

et al. 2005

American Journal of Transplantation

146

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Preservation techniques are crucial to deceased donor kidney transplantation (DDTx), but the efficacy of pulsatile perfusion (PP) versus cold storage (CS) remains uncertain. We describe patterns of PP use and explore four fundamental questions. What kidneys are selected for PP? How does PP affect utilization of donated kidneys? What effect does PP have on outcomes? When does PP appear to be most efficacious? We examined rates of PP in DDTx in the United States from 1994 to 2003. We generated models for organ utilization, delayed graft function (DGF) and for the use of PP. We analyzed the long-term effect of PP with multivariate Cox models. The utilization rates for nonexpanded criteria donors (ECDs) were similar by storage type, but for ECDs there was a significantly higher utilization rate with PP (70% with PP vs. 59% with CS, p < 0.001). Use of PP was widely variable across transplant centers. DGF rates were significantly lower with PP (27.6% vs. 19.6%). PP was associated with a mild benefit on death censored graft survival (adjusted hazard ratio = 0.88, 95% CI 0.85-0.91). Reduced DGF and significantly lower discard rates of ECDs associated with PP suggest an important utility of PP in renal transplantation. Additional evidence of improvement in graft survival, particularly in more recent years, provides further encouraging evidence for the use of PP.

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Early function of kidneys stored by continuous hypothermic pulsatile perfusion can be predicted using a new “viability index”

Cited by 21 publications

References 4 publications

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

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

Machine Perfusion Preservation Improves Renal Allograft Survival

Are We Frozen in Time? Analysis of the Utilization and Efficacy of Pulsatile Perfusion in Renal Transplantation

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