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Early experience with hypothermic machine perfusion of living donor kidneys - a retrospective study.
Transpl Int. 2017 Jul; 30(7):706-712.TI

Abstract

Although hypothermic machine perfusion (HMP) has been shown to be beneficial to deceased donor kidneys, the effect of HMP on living donor kidneys (LDK) is unknown. LDK are subjected to minutes of normothermic ischemia at the time of recovery. Comparison of 16 LDK preserved by HMP with 16 LDK preserved by static cold storage (SCS). Outcomes of interest are resistive indices (RI), both while on HMP and postoperatively, and creatinine clearance (CrCl). Injury markers NGAL and LDH were seen in the perfusate of LDK in amounts similar to what is found for donation after neurological determination of death kidneys. Compared to SCS kidneys, CrCl was significantly higher in the HMP group from days 2 through 7 post-transplant [ie: day 7 (78.8 ± 5.4 vs. 54.0 ± 4.6 ml/min, P = 0.005)]. CrCl at 1 year was higher in the HMP group (81.2 ± 5.8 vs. 70.0 ± 5.3 ml/min, P = 0.03). Early post-transplant RI was significantly lower in the HMP group (0.61 ± 0.02 vs. 0.71 ± 0.02, P < 0.0001). Our data support the assertion that injury does occur during LDK procurement and suggest that some of this injury may be reversed with HMP, resulting in more favorable early RI and graft function compared to SCS kidneys.

Authors+Show Affiliations

Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada. Saskatchewan Renal Transplant Program, Saskatoon, SK, Canada.Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada.Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada. Saskatchewan Renal Transplant Program, Saskatoon, SK, Canada.Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada. Saskatchewan Renal Transplant Program, Saskatoon, SK, Canada.Saskatchewan Renal Transplant Program, Saskatoon, SK, Canada.Saskatchewan Renal Transplant Program, Saskatoon, SK, Canada.Saskatchewan Renal Transplant Program, Saskatoon, SK, Canada.Saskatchewan Renal Transplant Program, Saskatoon, SK, Canada. Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.Department of Pharmacology, University of Saskatchewan, Saskatoon, SK, Canada. Department of Clinical Chemistry, Medical University of Wroclaw, Wroclaw, Poland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28390094

Citation

Moser, Michael A J., et al. "Early Experience With Hypothermic Machine Perfusion of Living Donor Kidneys - a Retrospective Study." Transplant International : Official Journal of the European Society for Organ Transplantation, vol. 30, no. 7, 2017, pp. 706-712.
Moser MAJ, Ginther N, Luo Y, et al. Early experience with hypothermic machine perfusion of living donor kidneys - a retrospective study. Transpl Int. 2017;30(7):706-712.
Moser, M. A. J., Ginther, N., Luo, Y., Beck, G., Ginther, R., Ewen, M., Matsche-Neufeld, R., Shoker, A., & Sawicki, G. (2017). Early experience with hypothermic machine perfusion of living donor kidneys - a retrospective study. Transplant International : Official Journal of the European Society for Organ Transplantation, 30(7), 706-712. https://doi.org/10.1111/tri.12964
Moser MAJ, et al. Early Experience With Hypothermic Machine Perfusion of Living Donor Kidneys - a Retrospective Study. Transpl Int. 2017;30(7):706-712. PubMed PMID: 28390094.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early experience with hypothermic machine perfusion of living donor kidneys - a retrospective study. AU - Moser,Michael A J, AU - Ginther,Nathan, AU - Luo,Yigang, AU - Beck,Gavin, AU - Ginther,Ronn, AU - Ewen,Marla, AU - Matsche-Neufeld,Rhianna, AU - Shoker,Ahmed, AU - Sawicki,Grzegorz, Y1 - 2017/05/21/ PY - 2016/11/08/received PY - 2016/12/31/revised PY - 2017/03/24/accepted PY - 2017/4/9/pubmed PY - 2018/6/5/medline PY - 2017/4/9/entrez KW - ischemia reperfusion injury KW - kidney KW - living donor KW - organ preservation and procurement SP - 706 EP - 712 JF - Transplant international : official journal of the European Society for Organ Transplantation JO - Transpl Int VL - 30 IS - 7 N2 - Although hypothermic machine perfusion (HMP) has been shown to be beneficial to deceased donor kidneys, the effect of HMP on living donor kidneys (LDK) is unknown. LDK are subjected to minutes of normothermic ischemia at the time of recovery. Comparison of 16 LDK preserved by HMP with 16 LDK preserved by static cold storage (SCS). Outcomes of interest are resistive indices (RI), both while on HMP and postoperatively, and creatinine clearance (CrCl). Injury markers NGAL and LDH were seen in the perfusate of LDK in amounts similar to what is found for donation after neurological determination of death kidneys. Compared to SCS kidneys, CrCl was significantly higher in the HMP group from days 2 through 7 post-transplant [ie: day 7 (78.8 ± 5.4 vs. 54.0 ± 4.6 ml/min, P = 0.005)]. CrCl at 1 year was higher in the HMP group (81.2 ± 5.8 vs. 70.0 ± 5.3 ml/min, P = 0.03). Early post-transplant RI was significantly lower in the HMP group (0.61 ± 0.02 vs. 0.71 ± 0.02, P < 0.0001). Our data support the assertion that injury does occur during LDK procurement and suggest that some of this injury may be reversed with HMP, resulting in more favorable early RI and graft function compared to SCS kidneys. SN - 1432-2277 UR - https://www.unboundmedicine.com/medline/citation/28390094/Early_experience_with_hypothermic_machine_perfusion_of_living_donor_kidneys___a_retrospective_study_ L2 - https://doi.org/10.1111/tri.12964 DB - PRIME DP - Unbound Medicine ER -