Machine perfusion of donation after cardiac death (DCD) kidneys

21 February 2014  //  Clinical Evidence

The Machine Preservation Trial was the first prospective, international randomized controlled trial comparing machine perfusion using LifePort with static cold storage.1 Rates of 1-year graft survival are significantly reduced in patients who experience delayed graft function (DGF).2 The use of donation after cardiac death (DCD) kidneys and expanded criteria donor (ECD) kidneys is increasing as the number of standard criteria donor (SCD) organs and organs donated after brain death decreases.3 The risk of DGF is higher in DCD and ECD kidneys than in SCD kidneys.4,5 Retrospective studies have suggested that machine perfusion could reduce the risk of DGF in all kidney types from deceased donors.6-8

The Machine Preservation Trial prospectively compared machine perfusion with cold storage with a primary endpoint of DGF. A total of 82 DCD kidney pairs were included in the sub-analysis. Kidney pairs were from consecutive donors and from each donor pair, one kidney was randomized to machine perfusion with LifePort® and the other to static cold storage.

Key results

In the overall analysis with DCD kidneys, compared with static cold storage, machine perfusion with LifePort significantly reduced the risk of DGF (adjusted odds ratio, 0.43; p=0.025) and the incidence (53.7% vs 69.5%; p=0.07; Relative Risk 0.77).

 
References

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