A Gallinat, et al. Universitätsklinikum Essen, Universitätsklinikum Bonn, Germany
The use of hypothermic machine perfusion (HMP) after initial storage on ice (end-ischemic HMP) reduces the rate of delayed graft function (DGF) and improves 1-year graft survival of kidneys compared with static cold storage (SCS) according to a study by researchers in Germany.
A total of 50 expanded criteria donor (ECD) kidney pairs were studied; one kidney from each pair was reconditioned using end-ischemic HMP, while the other remained in SCS until transplantation. Waiting time, the number of zero HLA mismatches and re-transplant rate were similar between groups. SCS kidneys had a shorter cold ischemia time than HMP kidneys (697 vs. 832 min; p=0.003).
Kidneys in the end-ischemic HMP cohort showed a lower DGF rate of 12% vs. 20.4% in the SCS group (p=0.24). Graft survival at 1 year was also improved at 98% vs. 86%, respectively (p=0.02), while patient survival was similar between groups (92% vs. 88%). All 50 end-ischemic HMP kidneys were transplanted, while 6 out of 50 (12%) SCS kidneys were discarded due to medical reasons.
The authors concluded that end-ischemic HMP leads to a reduction in DGF and significantly improved 1-year graft survival.