Introduction: Delayed graft function (DGF) negatively impacts kidney transplant (KT) outcomes. Our aim was to assess the impact of pulsatile machine perfusion (MP) on KT performed at two centers where standard criteria donors (SCD) are predominant. Methods: Prospective cohort including 180 KT performed from Jan/15 to Jul/17, who received paired kidneys from 90 deceased donors (DD) in which one group underwent MP and the other static cold storage (CS). The decision for MP or CS was at discretion of transplant center. The primary end-point was the incidence and duration of DGF. Results: DD were young (31±13 years), mixed race (80%), non-hypertensive (97%), non diabetic (100%), overweight (BMI 26±4kg/m[sup2]), who died due to traumatic brain injury (71%), with final serum creatinin of 1.3±0.7mg/dL. 95% were SCD with the mean KDPI and KDRI of 32±21% and 0.86±0.2, respectively. Demographic characteristics of the KT recipients were similar in both groups: males (60%), young (41±18 years), mixed race (86%), with chronic kidney disease of unknown etiology (38%), and time on dialysis (45±45 months). However, patients on MP group were higher immunological risk (HIR): panel reactive antibodies (PRA) 18±30 vs. 13±28% and pre-transplant donor specific antibodies (DSA) 17 vs. 3% (p=0.005). The total cold ischemia time (CIT) was 29±6 vs 21±4h (p<0.001), and dynamic CIT was 13±6h. MP significantly reduced the incidence of DGF (30 vs. 53%, p=0.002), and its duration, measured by the need of dialysis sessions (1.6 ± 4.1 vs 3.0 ± 6.0 , p=0.001). Conclusion: MP reduced the incidence of DGF and the need for dialysis, even when using SCD. Despite HIR, patients who received MP kidneys presented lower incidence of DGF. This cohort will be followed to assess the impact of DGF reduction on long-term outcomes.

CITATION INFORMATION: Costa S., Sandes-Freitas T., Fernandes P., Esmeraldo R. Impact of Pulsatile Perfusion Machine on Postoperative Outcomes in Standard Criteria Donor Kidney Transplants Am J Transplant. 2017;17 (suppl 3).

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