Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Sevinc, Mustafa; Stamp, S; Carter, N.; Talbot, D; Sheerin, Neil

doi:10.1016/j.transproceed.2016.09.049

Cited by 13 publications

(6 citation statements)

References 25 publications

(31 reference statements)

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“…They found the 1‐h perfusate flow to be independently associated with DGF, however with a meager AUC of 0.57 . Later studies by different groups have confirmed these results .…”

Section: Current Methodsmentioning

confidence: 92%

Evaluation of donor kidneys prior to transplantation: an update of current and emerging methods

Moeckli

Sun

Lazeyras³

et al. 2019

Transpl Int

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Summary The lack of suitable kidney donor organs has led to rising numbers of patients with end stage renal disease waiting for kidney transplantation. Despite decades of clinical experience and research, no evaluation process that can reliably predict the outcome of an organ has yet been established. This review is an overview of current methods and emerging techniques in the field of donor kidney evaluation prior to transplantation. Established techniques like histological evaluation, clinical scores, and machine perfusion systems offer relatively reliable predictions of delayed graft function but are unable to consistently predict graft survival. Emerging techniques including molecular biomarkers, new imaging technologies, and normothermic machine perfusion offer innovative approaches toward a more global evaluation of an organ with better outcome prediction and possibly even identification of targets for therapeutic interventions prior to transplantation. These techniques should be studied in randomized controlled trials to determine whether they can be safely used in routine clinical practice to ultimately reduce the discard rate and improve graft outcomes.

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“…They found the 1‐h perfusate flow to be independently associated with DGF, however with a meager AUC of 0.57 . Later studies by different groups have confirmed these results .…”

Section: Current Methodsmentioning

confidence: 92%

Evaluation of donor kidneys prior to transplantation: an update of current and emerging methods

Moeckli

Sun

Lazeyras³

et al. 2019

Transpl Int

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“…Machine perfusion data including machine type, perfusion flow index (PFI), resistance (RT) [16], and…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Outcome of Kidney Transplant After Pulsatile or Continuous Ex Vivo Hypothermic Machine Perfusion of Kidneys Donated After Cardiac Death: Analysis of Kidney Pairs

Sevinc

Stamp

Ling

et al. 2019

Transplantation Proceedings

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“…This parameter is calculated by dividing the flow rate by resistance and expressed as mL/min/mmHg per 100 g of kidney. A cut-off PFI of 1.08 showed significant differences in graft survival with a sensitivity of 71% and specificity of 38% (21).…”

Section: Perfusion Parameters As Predictors Of Outcomementioning

confidence: 96%

Machine preservation of donor kidneys in transplantation

Patel

Şener

Bhattacharjee

et al. 2019

Transl. Androl. Urol

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With increasing demands for 'less than ideal' kidneys for transplantation, machine perfusion of kidneys has been utilized to improve the preservation of kidneys during storage. Hypothermic machine perfusion (HMP) of renal allografts has been shown to reduce delayed graft function rates in both expanded criteria and donation after cardiac death renal allografts. However, the beneficial impact upon long-term graft function is unclear. There has been emerging evidence that both subnormothermic (room temperature) and normothermic machine perfusion (NMP) of allografts have beneficial effects with regards to early graft function, survival and injury in pre-clinical and early clinical studies. Additionally, machine perfusion allows functional assessment of the organ prior to transplantation. Ultimately, the greatest benefit of machine perfusion may be the ability to treat the organ with agents to protect the graft against ischemia reperfusion injury, while awaiting transplantation.

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Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Cited by 13 publications

References 25 publications

Evaluation of donor kidneys prior to transplantation: an update of current and emerging methods

Evaluation of donor kidneys prior to transplantation: an update of current and emerging methods

Comparison of the Outcome of Kidney Transplant After Pulsatile or Continuous Ex Vivo Hypothermic Machine Perfusion of Kidneys Donated After Cardiac Death: Analysis of Kidney Pairs

Machine preservation of donor kidneys in transplantation

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