Using renal resistance to predict outcomes

15 May 2014  //  Clinical Evidence

Renal resistances during machine perfusion are believed to be predictive of transplant outcomes and are frequently used as a reason to discard kidneys prior to transplant.1 However, renal resistance threshold values have never been studied in a prospective randomized study. In this trial, 2,336 kidney pairs (672 recipients) were studied to examine the prognostic value of renal resistance on delayed graft function (DGF), primary non‐function (PNF) and graft survival of deceased donor kidneys. Kidney pairs were from consecutive donors and all deceased-donor kidney types were included. From each donor pair, one kidney was randomized to machine perfusion with LifePort Kidney Transporter and the other to static cold storage. In the machine preservation group, renal resistance was recorded to determine impact on DGF, PNF and graft survival.

Key results

Data analysis found renal resistance at the end of hypothermic machine perfusion is an independent risk factor for both DGF (odds ratio 38.1; p=0.026) and 1-year graft failure (hazard ratio 12.33; p=0.004).

The authors concluded that renal resistance is an important additional factor that can be used to assess the quality of kidney grafts, but should not be used as a stand-alone assessment tool in the decision to accept or discard organs.

References

1. Moers C, et al. N Engl J Med 2009;360:7-19.
2. Jochmans I, et al. Am J Transplant 2011;11:2214–20.