Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Recent evidence suggests that hypothermic machine perfusion of donor kidneys reduces delayed graft function (DGF), but data is sparse on its effect on allograft rejection. This study addresses the effect of machine perfusion on allograft rejection and survival rates in the United States.
Methods: We assembled a retrospective cohort of patients undergoing kidney-alone transplants in the United Network for Organ Sharing data from June 30, 2004 through June 30, 2014. KDRI was calculated from the available component variables. Multivariable logistic regression adjusted for recipient age, KDRI, and cold ischemic time evaluated the effect of kidney pump use on graft rejection, DGF, and graft survival. Subgroup analysis was undertaken in quartiles of KDRI.
Results: Records for 167,125 first-time transplants were abstracted, 40,410 (24%) of which had been pumped in transit or at the receiving transplant center. Kidneys placed on the pump had higher median KDRI (0.75 vs 0.71) and longer cold ischemic times (19.24 vs 7.87 hr). 3,778 (2.26%) of recipients had at least one episode of treated rejection. 28,088 (16.86%) required dialysis within the first week of transplant, 34.46% of whom eventually progressed to graft failure. Recipients of pumped kidneys were less likely to require dialysis within the first week of transplant (OR 0.91, 95% CI 0.88-0.94). Of those requiring dialysis within the first week, recipients of pumped kidneys were less likely to progress to graft failure (OR 0.92 95% CI 0.87-0.98). These effects were consistent among all quartiles of KDRI. Pumped kidneys were not more likely to have rejection (OR 0.99, 95% CI 0.91-1.09).
Summary: In conclusion, pumping donor kidneys reduces DGF and reduces the risk of progression to graft failure, but does not affect rates of allograft rejection.
CITATION INFORMATION: Samoylova M., Nash A., Brennan T. Pumping Donor Kidneys Reduces DGF and Improves Allograft Survival without Affecting Rejection Rates Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Samoylova M, Nash A, Brennan T. Pumping Donor Kidneys Reduces DGF and Improves Allograft Survival without Affecting Rejection Rates [abstract]. https://atcmeetingabstracts.com/abstract/pumping-donor-kidneys-reduces-dgf-and-improves-allograft-survival-without-affecting-rejection-rates/. Accessed September 23, 2021.
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