Long Term Cold Ischemia Time in Kidney Transplantation. The Role of Hypothermic Machine Perfusion
1General Surgery and Transplantation, Academic Hospital P. le S.M. della Misericordia, 33100 Udine, Italy, Udine, Italy, 2Nephrology, Dialysis and Kidney Transplantation, Academic Hospital P. le S.M. della Misericordia, 33100 Udine, Italy, Udine, Italy
Meeting: 2019 American Transplant Congress
Abstract number: B5
Keywords: Cadaveric organs, Graft function, Kidney transplantation, Machine preservation
Session Information
Session Name: Poster Session B: Ischemia Reperfusion & Organ Rehabilition
Session Type: Poster Session
Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Hypothermic machine perfusion (HMP) of deceased donor kidneys is associated with a better outcome than static cold storage (SCS). Aim of this prospective study is to evaluate the role of concomitant SCS and HMP in transplanted kidney with a cold ischemia time (CIT) over 24 hours, on post-operative outcome.
*Methods: A prospective analysis was conducted on 18 single kidney grafts suitable for transplantation from standard or expanded criteria donors. The recipients were divided into two groups based on duration of CIT: group A (24-28 hours) 8 cases, and group B (29-33 hours) 10 cases.
*Results: Statistical analysis did not evidence differences in donor and recipient characteristics. Correlating group A vs B, CIT was longer in group B (p=0.001). SCS was longer (p=0.001) in group B, while HMP time showed no statistically significant differences (p=0.19). The flow at the beginning of HMP was higher for group A (p=0.036) reflecting lower arterial vascular resistance of group A vs B (p=0.015). At the ending of HMP arterial resistances showed no difference between the groups (p=0.14), as well as the renal flow (p=0.17). A statistically significant differences (P 0,0001, 0,004, 0,003, 0,005 respectively) has been evidenced analyzing PH, PO2, lactates, and glucose before and after MP, but no differences between group A and B (p=0,85). No other differences have been founded during HMP. No statistically significant differences have been evidenced between the two groups in term of delay graft function (1 case for both), acute rejection (1 case in group A vs 2 cases in group B), diuresis, creatinine, and clearance of creatinine in the first three months after transplantation. Furthermore, HMP does not appear to modify in any apparent and predictable fashion neither nuclear nor cytoplasmic damage that appear to remain stable throughout the period of HMP analyzed histologically from renal biopsies performed immediately before and after HMP.
*Conclusions: Long SCS affects the initial arterial vascular resistances at the beginning of HMP, but no differences have been evidenced at the ending of the procedure. HMP has a role in the functional recovery without anatomopathological or clinical damages to the graft.
To cite this abstract in AMA style:
ADANI G, Baccarani U, Tulissi P, Vallone C, Risaliti A. Long Term Cold Ischemia Time in Kidney Transplantation. The Role of Hypothermic Machine Perfusion [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/long-term-cold-ischemia-time-in-kidney-transplantation-the-role-of-hypothermic-machine-perfusion/. Accessed May 19, 2025.« Back to 2019 American Transplant Congress