BACKGROUND: Hypothermic machine perfusion (HMP) of kidneys is intended to mitigate the deleterious effects of cold storage on organ quality, particularly when the cold ischemic time is prolonged or the donor is otherwise marginal. The use of HMP has remained controversial; however, a number of randomized controlled trials (RCTs) have recently been conducted to clarify its benefits. METHODS: We undertook a systematic search of the Medline and Embase databases and of the Cochrane Central Register of Controlled Trials. We included only RCTs in the meta-analysis. Outcomes analyzed were the incidence of delayed graft function (DGF), primary nonfunction (PNF), graft loss, and patient death at 1 y. RESULTS: We identified seven RCT trials and subjected them to meta-analysis, including 1353 kidney transplant recipients. Hypothermic machine perfusion significantly reduced the incidence of DGF (risk ratio [RR] 0.83, 95% confidence interval [CI] 0.72-0.96). There was no difference in the incidence of PNF (RR 0.78, 95% CI 0.36-1.68), graft loss at 1 y (RR 0.87, 95% CI 0.64-1.19), and patient death at 1 y (RR 0.91, 95% CI 0.60-1.37) between HMP and donor kidneys preserved using cold storage. CONCLUSIONS: There are few RCT comparing HMP and cold storage of kidneys in deceased donor kidney transplantation. Although these studies are small and heterogeneous in design, HMP appeared to be associated with a reduced incidence of DGF. No difference in the incidence of PNF, graft loss, or patient death at 1 y could be demonstrated. Crown
BACKGROUND: Hypothermic machine perfusion (HMP) of kidneys is intended to mitigate the deleterious effects of cold storage on organ quality, particularly when the cold ischemic time is prolonged or the donor is otherwise marginal. The use of HMP has remained controversial; however, a number of randomized controlled trials (RCTs) have recently been conducted to clarify its benefits. METHODS: We undertook a systematic search of the Medline and Embase databases and of the Cochrane Central Register of Controlled Trials. We included only RCTs in the meta-analysis. Outcomes analyzed were the incidence of delayed graft function (DGF), primary nonfunction (PNF), graft loss, and patient death at 1 y. RESULTS: We identified seven RCT trials and subjected them to meta-analysis, including 1353 kidney transplant recipients. Hypothermic machine perfusion significantly reduced the incidence of DGF (risk ratio [RR] 0.83, 95% confidence interval [CI] 0.72-0.96). There was no difference in the incidence of PNF (RR 0.78, 95% CI 0.36-1.68), graft loss at 1 y (RR 0.87, 95% CI 0.64-1.19), and patient death at 1 y (RR 0.91, 95% CI 0.60-1.37) between HMP and donor kidneys preserved using cold storage. CONCLUSIONS: There are few RCT comparing HMP and cold storage of kidneys in deceased donor kidney transplantation. Although these studies are small and heterogeneous in design, HMP appeared to be associated with a reduced incidence of DGF. No difference in the incidence of PNF, graft loss, or patient death at 1 y could be demonstrated. Crown
Authors: Michael A J Moser; Steve Arcand; Han-Bin Lin; Chris Wojnarowicz; Jolanta Sawicka; Tamalina Banerjee; Yigang Luo; Gavin R Beck; Patrick P Luke; Grzegorz Sawicki Journal: PLoS One Date: 2016-06-21 Impact factor: 3.240
Authors: Anja Bienholz; Björn Walter; Gesine Pless-Petig; Hana Guberina; Andreas Kribben; Oliver Witzke; Ursula Rauen Journal: PLoS One Date: 2017-07-03 Impact factor: 3.240
Authors: Helio Tedesco-Silva; Juliano Chrystian Mello Offerni; Vanessa Ayres Carneiro; Mayara Ivani de Paula; Elias David Neto; Francine Brambate Carvalhinho Lemos; Lúcio Roberto Requião Moura; Alvaro Pacheco E Silva Filho; Mirian de Fátima de Morais Cunha; Erica Francisco da Silva; Luiz Antonio Miorin; Daniela Priscila Demetrio; Paulo Sérgio Luconi; Waldere Tania da Silva Luconi; Savina Adriana Bobbio; Liz Milstein Kuschnaroff; Irene Lourdes Noronha; Sibele Lessa Braga; Renata Cristina Barsante; João Cezar Mendes Moreira; Ida Maria Maximina Fernandes-Charpiot; Mario Abbud-Filho; Luis Gustavo Modelli de Andrade; Paula Dalsoglio Garcia; Luciana Tanajura Santamaria Saber; Alan Fernandes Laurindo; Pedro Renato Chocair; Américo Lourenço Cuvello Neto; Juliana Aparecida Zanocco; Antonio Jose Duboc de Almeida Soares Filho; Wilson Ferreira Aguiar; Jose Medina Pestana Journal: Transplant Direct Date: 2017-04-18
Authors: Michael A J Moser; Katherine Sawicka; Steven Arcand; Preston O'Brien; Patrick Luke; Gavin Beck; Jolanta Sawicka; Alejandro Cohen; Grzegorz Sawicki Journal: Ann Transplant Date: 2017-12-08 Impact factor: 1.530