In a first of its kind study, the long-term outcomes of paired kidneys maintained with static cold storage (SCS) versus hypothermic machine perfusion (HMP) following transplantation were investigated. A total of 202 patients were included in the study. The first kidney of the pair was selected at random to be maintained in SCS, while the second kidney was transplanted at a later date following HMP (initiated immediately following extraction). Doppler ultrasound parameters and 2-year allograft function were determined for both HMP and SCS groups.
Recipients of HMP kidneys had persistently higher estimated glomerular filtration rates (eGFRs) over 2 years than those receiving SCS kidneys (p=0.013). Despite longer cold ischemic times, kidneys in the HMP group also showed markedly reduced resistive indices at 1-week post-transplantation. Day 1 resistive indices were not found to be statistically different between HMP and SCS groups, possibly indicating that HMP assists with gradual renal recovery over the first week.
A subgroup analysis found that the HMP-induced improvement in post-operative eGFR was largest in kidneys donated after cardiac death (DCD), even at 2 years post-transplant (p=0.008).
Dion MS, et al. BJU Int. 2014 Oct 18. [Epub ahead of print].