Machine perfusion and long-term kidney transplant recipient outcomes across allograft risk strata

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Shaifali SandalDorry L Segev

Abstract

The use of machine perfusion (MP) in kidney transplantation lowers delayed graft function (DGF) and improves 1-year graft survival in some, but not all, grafts. These associations have not been explored in grafts stratified by the Kidney Donor Profile index (KDPI). We analyzed 78 207 deceased-donor recipients using the Scientific Registry of Transplant Recipients data from 2006 to 2013. The cohort was stratified using the standard criteria donor/expanded criteria donor (ECD)/donation after cardiac death (DCD)/donation after brain death (DBD) classification and the KDPI scores. In each subgroup, MP use was compared with cold storage. The overall DGF rate was 25.4% and MP use was associated with significantly lower DGF in all but the ECD-DCD donor subgroup. Using the donor source classification, the use of MP did not decrease death-censored graft failure (DCGF), except in the ECD-DCD subgroup from 0 to 1 year {adjusted hazard ratio [aHR] 0.56 [95% confidence interval (CI) 0.32-0.98]}. In the ECD-DBD subgroup, higher DCGF from 1 to 5 years was noted [aHR 1.15 (95% CI 1.01-1.31)]. Also, MP did not lower all-cause graft failure except in the ECD-DCD subgroup from 0 to 1 year [aHR = 0.59 (95% CI 0.38-0.91)]. Using the KDPI classifica...Continue Reading

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Citations

Mar 2, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Shaifali SandalRuth Sapir-Pichhadze
Jul 12, 2019·Current Diabetes Reports·Karim Hamaoui, Vassilios Papalois
May 14, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Camille LegeaiOlivier Bastien
Jun 2, 2020·Frontiers in Immunology·Thomas ReschSefan Schneeberger
Sep 11, 2020·Transplantation·Tommy IvanicsGonzalo Sapisochin
Jun 23, 2021·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Paloma Barreda MonteolivaEmilio Rodrigo Calabria
Jul 14, 2021·American Journal of Surgery·Navdeep SinghKenneth Washburn

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