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The Impact of Hypothermic Pulsatile Machine Perfusion Versus Static Cold Storage: A Donor-Matched Paired Analysis in a Scenario of High Incidence of Delayed Kidney Graft Function.
de Sandes-Freitas, Tainá Veras; Costa, Silvana Daher; de Andrade, Luis Gustavo Modelli; Girão, Celi Melo; Fernandes, Paula Frassinetti Castelo Branco Camurça; de Oliveira, Claudia Maria Costa; Esmeraldo, Ronaldo de Matos.
Afiliação
  • de Sandes-Freitas TV; Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
  • Costa SD; Transplant Division, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
  • de Andrade LGM; Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
  • Girão CM; Transplant Division, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
  • Fernandes PFCBC; Department of Internal Medicine, Paulista State University - UNESP, Botucatu, SP, Brazil.
  • de Oliveira CMC; Transplant Division, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
  • Esmeraldo RM; Walter Cantídio University Hospital, Fortaleza, CE, Brazil.
Ann Transplant ; 25: e927010, 2020 Dec 15.
Article em En | MEDLINE | ID: mdl-33318465
BACKGROUND The present study analyzed the impact of hypothermic pulsatile machine perfusion (MP) following a long period of static cold (SC) storage in the peculiar Brazilian scenario of high incidence of delayed graft function (DGF), despite good donor characteristics. MATERIAL AND METHODS A retrospective analysis, with a 1-year follow-up, of 206 recipients of donor-matched paired kidneys was performed. Of the 206 donor kidneys, 103 were maintained exclusively in static cold storage (SC group) and 103 were kept on machine perfusion after a period of SC preservation (MP group). All donors were brain dead. RESULTS Only 4.9% of the kidneys were from expanded-criteria donors. Static cold ischemia time (CIT) in the SC group was 20.8±4.1 hours vs. 15.8±6.2 hours in the MP group (P<0.001). Dynamic CIT in the MP group was 12.3±5.7 hours. MP significantly reduced DGF incidence (29.1% vs. 55.3%, P<0.001), and this effect was confirmed in multivariable analysis (OR, 1.115; 95% CI, 1.033-1.204, P=0.001). No differences were observed between the groups with regard to DGF duration, length of hospital stay, incidence of primary nonfunction and acute rejection, graft loss, death, or renal function. CONCLUSIONS In this Brazilian setting, MP following a long period of SC preservation was associated with reduced DGF incidence in comparison with SC storage without MP.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preservação de Órgãos / Transplante de Rim / Função Retardada do Enxerto Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Ann Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
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XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preservação de Órgãos / Transplante de Rim / Função Retardada do Enxerto Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Ann Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos