Predicting 1-year outcomes using machine measured renal resistance

10 February 2013  //  Clinical Evidence

A retrospective analysis was undertaken to investigate the correlation of different donor parameters such as sex, age, race, glomerular filtration rate, terminal creatinine level, and various renal allograft biopsy parameters and machine-measured renal resistance (MMRR) with 1-year renal function and allograft outcomes. A total of 454 kidneys were included in the analysis. Kidneys procured locally were placed on LifePort Kidney Transporter in the donor OR and had a mean cold ischemia time (CIT) of 19.14 hours. Kidneys procured from outside of the local area were initially placed on ice (except for 16 kidneys that had been placed on a LifePort), with a mean CIT of 32.32 hours. Prior to transplantation, all kidneys were placed on a LifePort and perfused for a minimum of 5 hours.

Key results

Data showed a significant inverse relationship of MMRR at 3 and 5 hours to 1-year graft survival. Other risk factors such as donor sex, donor type, glomerulosclerosis, tubular interstitial scarring and arterial intimal fibrous narrowing had no correlation with 1-year graft survival.

Patients with an MMRR > 0.3 at both 3 and 5 hours have a significantly higher risk for adverse 1-year renal allograft outcomes. The data show MMRR at 3 hours can be used as the earliest predictive tool for 1-year renal allograft survival.

Reference

Yushkov YY, et al. Prog Transplant. 2012;22(2):175–82.