Machine Perfusion or Cold Storage in Deceased-Donor Kidney Transplantation

Abstract

1 report on their trial of machine perfusion versus static storage of kidneys from deceased donors. The benefit of machine perfusion 2 is probably that it ensures a uniform distribution of preservation fluid throughout the organ, which is better than a single flush.Perhaps this benefit can be illustrated best by our experience with a series of 38 poorly preserved kidneys obtained at our center from 19 donors after cardiac death, all of whom had undergone femoral cannulation and were Maastricht category II or III donors. 3 (Patients in Maastricht category III generally had a misplaced cannula.) In these donors, the kidneys were blue and poorly perfused at laparotomy, and these indicators did not improve with a single flush after recovery. On the basis of standard criteria, these organs were not suitable for transplantation; however, after machine perfusion, only four kidneys were not transplant ed. The appearance and flow were improved by means of machine perfusion, and this method of preservation resulted in 10 dual and 14 single kidney transplantations.Machine perfusion may improve the appearance and usability of kidneys that otherwise would not be transplanted. 4

Serum Uric Acid and Renal Transplantation Outcomes: At Least 3-Year Post-transplant Retrospective Multivariate Analysis

“…To estimate the impact of UA level and hyperuricemia on long-term transplant outcomes, Cox proportional hazard model was used to adjust for confounding factors. In accordance with our expectation, hyperuricemia was found to be a significant predictor for graft loss (defined as allograft failure and death) during the study period(hazard ratio [ 36 ] = 2.17, 95% confidential interval[CI]:1.27–3.70, P = 0.004) as illustrated in Fig 4 . However, it was not valid(HR = 1.59, 95% CI: 0.73–3.44, P = 0.241) after adjustment for age, gender, BMI, HLA mismatch, introduction regimen, immunosuppressive agent protocol, diabetic mellitus, dialysis type, DGF, infection and acute rejection episode.…”