Use of Perfusion Machine after Long Cold Ischemia Time: 3 Years Results
1Transplant, Hospital Israelita Albert Einstein, São Paulo, Brazil
2Nephrology, Universidade Federal de São Paulo, São Paulo, Brazil.
Meeting: 2018 American Transplant Congress
Abstract number: D138
Keywords: Ischemia, Kidney transplantation, Machine preservation, Outcome
Session Information
Session Name: Poster Session D: Kidney Donor Selection / Management Issues
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
The rate of delayed graft function (DGF) in Brazil is very high, reaching 80%. This is due to the long cold ischemia time (TIF) and inadequate care of the donor in brain death. Some centers in Brazil have used the perfusion machine (PM) to try to decrease the rate of DGF. Objective: To evaluate the clinical impact of MP after long staticTIF. METHODS: We included 186 kidney transplant recipients who used PM from 02/13 to 12/2016, excluding cases of early losses due to technical causes and kidneys that came from other centers using PM. The kidneys are maintained in PM for at least 6 hours and hemodynamic parameters are monitored during their stay. For this analysis, patients were divided into two groups, according to the evolution: DGF or non-DGF and their outcomes were compared. Risks for the DGF were analysed from recipient, donor, transplant and PM data. Outcomes analyzed: DGF rate, DGF days, days of hospitalization, creatinine (Cr) at discharge, 1, 6 and 12 months after transplantation, graft deaths and losses. Results: The mean age of the patients was 48.5 ± 1.9 ys, with 59% being male, with a dialysis time of 46.5 ± 5.3 mo. The donor age was 41.0 ± 2.0 yrs, vascular was the main cause of death (47%). The mean KDPI was 54.6 ± 3.9. The total cold ischemia time, pumping time and static TIF were 2075.5 ± 68.0 min, 812.6 ± 46.9 min and 1273.0 ± 54.2 min respectively. The DGF rate was 58.6%, the DGF risk calculation was 46.4% and the duration of DGF was 10.1 ± 2.3 days. Variables statistically different (p <0.05) between the two groups were: longer dialysis time, greater donor age, more donor vascular death, higher donor Cr and higher KDPI in the DGF group. Reduced hospitalization time (21.5 ± 2.9 versus 11.9 ± 1.7 days p <0.05) and lower values of Cr in all analyzed periods (p <0.05) were observed in the non-DGF group. There was no difference in the number of losses and deaths between the groups. In the multivariate analysis, KDPI and staticTIF were independently associated with DGF, OR: 1.023 and OR: 1,001, p <0.001 and p = 0.009, respectively. Conclusion: Patients without DGF had more rapid recovery of renal function and early discharge. Medium-term outcomes were better in the non-DGF group. The characteristics of the donors and the higher staticTIF influenced the DGF.
CITATION INFORMATION: Matos A., Requião-Moura L., Tonato E., Souza-Durão M., Borrelli M., Nogueira M., Rubio P., Pacheco-Silva A. Use of Perfusion Machine after Long Cold Ischemia Time: 3 Years Results Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Matos A, Requião-Moura L, Tonato E, Souza-Durão M, Borrelli M, Nogueira M, Rubio P, Pacheco-Silva A. Use of Perfusion Machine after Long Cold Ischemia Time: 3 Years Results [abstract]. https://atcmeetingabstracts.com/abstract/use-of-perfusion-machine-after-long-cold-ischemia-time-3-years-results/. Accessed November 23, 2024.« Back to 2018 American Transplant Congress