L. Szabo B. Cook A. AsderakisE. Ablorsu

Cardiff Transplant UnitCardiffUK

HYPOTHERMIC MACHINE PERFUSION

IMPROVES OUTCOMES IN DCD KIDNEYS WITH LONG COLD ISCHEMIA

TIME

BACKGROUND

Number of donors in the UK

BACKGROUND

Age of deceased donors in the UK

To assess the effect of hypothermic pulsatile machine perfusion (MP) on the early function of DCD kidneys

AIM

Prospective, non-randomized observational study

From 1 Jan 2011 to 31 May 2012 69 consecutive DCD kidney transplants ExcludedDouble kidney transplantsKidney-pancreas transplants

METHOD

Assessed parametersDonor age, CIT, type of storage (MP v CS)

OutcomeseGFR @ 1 monthdDGF (need of HD), fDGF (functional)

METHOD

DCD kidneys are allocated locally in the UK In our centre DCD kidneys are transplanted

without Xmatch to an antibody negative patient (virtual XM)

MP (n=42)if any delay occurred and long CIT was anticipated2nd kidney if a pair was allocated to our centre

CS (n=27)Short CIT, no delay

ALLOCATION OF DCD KIDNEYS

RESULTS

HMP (n=42)

CS(n=27)

p

Donor age

58.21± 15.49 59.87 ± 10.71 0.629

Donor creatinine

69.50 ± 19.22 73.52 ± 22.50 0.431

Recipient age

59.06 ± 12.12 60.66 ± 11.40 0.587

CIT 14.73 ± 4.50 9.90 ± 4.67 <0.001

Odds ratio 3.85

INCIDENCE OF DGF

dDGF

fDGF

LOGISTIC REGRESSION

  B S.E. p Exp(B)

Donor age 0.036 0.021 0.093 1.036

CIT 0.049 0.063 0.444 1.050

MP / CS 1.717 0.648 0.008 5.565

Constant −3.318 1.583 0.036 0.036

B S.E. p Exp(B)

Donor age 0.052 0.022 0.016 1.053

CIT 0.072 0.072 0.321 1.074

MP / CS 0.997 0.720 0.166 2.710

Constant −3.292 1.670 0.049 0.037

GFR

GFR @ 1 Month

MULTIPLE REGRESSION

Unstandardized Coefficients

Standardized Coefficients t p

B Std. Error Beta

(Constant) 92.607 9.016   10.271 <0.001

Donor age −0.770 0.133 −0.550 −5.798 <0.001

CIT −1.059 0.402 −0.281 −2.631 0.011

MP / CS 11.026 4.188 0.281 2.633 0.011

MP, on DCD kidneys, can neutralize the adverse effect of the long CIT,

leading to at least equivalent early graft function (GFR),

lower rates of dDGF

CONCLUSION