Impact of Machine Perfusion After Long Static Cold Storage On Delayed Graft Function Incidence and Duration and Time to Hospital Discharge

A. Matos,¹ M. Borrelli, Jr.,¹ L. Moura Requiao,¹ M. Nogueira, Jr.,¹ L. Pertusier,¹ G. Clarizia,¹ P. Ongaro,¹ S. Ximenes,¹ M. Durao, Jr.,^1,2 A. Pacheco-Silva.^1,2

¹Transplantation, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
²Medicine/Nephrology, Escola Paulista de Medicina, UNIFESP, Sao Paulo, Brazil.

Meeting: 2015 American Transplant Congress

Abstract number: B91

Keywords: Adverse effects, Cadaveric organs, Graft function, Preservation

Session Information

Session Name: Poster Session B: Kidney and Donor Evaluation/Utilization

Session Type: Poster Session

Date: Sunday, May 3, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Our transplant center is not involved in organ harvesting and usually we receive a kidney for transplant with more then 20 hours of static cold ischemia time. Associated to this long cold ischemia time, there is also an inadequate care of the donors which reflects in a very high incidence of DGF (70-80%). This high incidence of DGF is associated to a longer hospitalization, poorer long term graft survival and higher costs. We decided to test the machine perfusion to improve the outcome of our transplant patients. The objective of this work is to analyze the incidence of DGF, its duration and the time of hospitalization after transplantation in patients who received a kidney preserved in the machine perfusion (MP Group) after a long time of cold storage. We report the data from 54 kidneys from DD preserved in the MP transplanted from 2/2013 to 07/2014 and compare their evolution to 101 kidney transplants preserved by Cold storage (Control Group), realized from 11/2008 to 5/2012 at our transplant center. Results: The median total ischemia time was 31,5 hr (20 hr CS plus 11,5 hr MP) for MP and 22 hr for Control Group (p<0,001). Donor age (42,5 x43 yr), Creatinine (1,30 x 1,32mg/dl) and death by stroke (42,6% x 52,5%) were not significantly different between MP and Control groups. DGF incidence was 61,1% for MP compared to 79,2% in the control group (p= 0,02). Median DGF duration (days on dialysis) was 1 in the MP compared to 9 days in the control group (p<0,001). The hospital discharge was 13 days after transplantation for the MP and 18 days for the control group (p<0,011) and the median CrCl at discharge was 55ml/min for MP and 57ml/min for the control group (p=0,256). In multivariate analysis, risk factors for DGF, adjusted for CS ischemia time, were donor age (OR: 1,04 p=0,005) and absence of use of machine perfusion group (OR: 1,54 p=0,051). In conclusion, the use of MP after along static cold ischemia and inadequate care of the donor decreases DGF, contributed to a faster recovery of renal function and to a shorter time of hospitalization.

To cite this abstract in AMA style:

Matos A, Borrelli M, Requiao LMoura, Nogueira M, Pertusier L, Clarizia G, Ongaro P, Ximenes S, Durao M, Pacheco-Silva A. Impact of Machine Perfusion After Long Static Cold Storage On Delayed Graft Function Incidence and Duration and Time to Hospital Discharge [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-machine-perfusion-after-long-static-cold-storage-on-delayed-graft-function-incidence-and-duration-and-time-to-hospital-discharge/. Accessed November 21, 2024.

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