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Title: | Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants With High Incidence of Delayed Graft Function |
Authors: | TEDESCO-SILVA JUNIOR, Helio; OFFERNI, Juliano Chrystian Mello; CARNEIRO, Vanessa Ayres; PAULA, Mayara Ivani de; NETO, Elias David; LEMOS, Francine Brambate Carvalhinho; MOURA, Lucio Roberto Requiao; SILVA FILHO, Alvaro Pacheco e; CUNHA, Mirian de Fatima de Morais; SILVA, Erica Francisco da; MIORIN, Luiz Antonio; DEMETRIO, Daniela Priscila; LUCONI, Paulo Sergio; LUCONI, Waldere Tania da Silva; BOBBIO, Savina Adriana; KUSCHNAROFF, Liz Milstein; NORONHA, Irene Lourdes; BRAGA, Sibele Lessa; BARSANTE, Renata Cristina; MOREIRA, Joao Cezar Mendes; FERNANDES-CHARPIOT, Ida Maria Maximina; ABBUD-FILHO, Mario; ANDRADE, Luis Gustavo Modelli de; GARCIA, Paula Dalsoglio; SABER, Luciana Tanajura Santamaria; LAURINDO, Alan Fernandes; CHOCAIR, Pedro Renato; CUVELLO NETO, Americo Lourenco; ZANOCCO, Juliana Aparecida; SOARES FILHO, Antonio Jose Duboc de Almeida; AGUIAR, Wilson Ferreira; PESTANA, Jose Medina |
Citation: | TRANSPLANTATION DIRECT, v.3, n.5, article ID e155, 8p, 2017 |
Abstract: | Background. This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). Methods. In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF. Secondary endpoints included the duration of DGF, hospital stay, primary nonfunction, estimated glomerular filtration rate, acute rejection, and allograft and patient survivals. Results. Mean cold ischemia time was high but not different between the 2 groups (25.6 +/- 6.6 hours vs 25.05 +/- 6.3 hours, 0.937). The incidence of DGF was lower in the machine perfusion compared with cold storage group (61% vs. 45%, P = 0.031). Machine perfusion was independently associated with a reduced risk of DGF (odds ratio, 0.49; 95% confidence interval, 0.26-0.95). Mean estimated glomerular filtration rate tended to be higher at day 28 (40.6 +/- 19.9 mL/min per 1.73 m(2) vs 49.0 +/- 26.9 mL/min per 1.73 m(2); P = 0.262) and 1 year (48.3 +/- 19.8 mL/min per 1.73 m2 vs 54.4 +/- 28.6 mL/min per 1.73 m(2); P = 0.201) in the machine perfusion group. No differences in the incidence of acute rejection, primary nonfunction (0% vs 2.5%), graft loss (7.5% vs 10%), or death (8.8% vs 6.3%) were observed. Conclusions. In this cohort of recipients of deceased donor kidneys with high mean cold ischemia time and high incidence of DGF, the use of continuous machine perfusion was associated with a reduced risk of DGF compared with the traditional cold storage preservation method. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - HC/ICHC |
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