Oxygenated End-Hypothermic Machine Perfusion in Expanded Cri
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Continuous hypothermic machine perfusion during organ preservation has a beneficial effect on graft function and survival in kidney transplants when compared with static cold storage (SCS). The findings of the JAMA study suggest that the use of oxygenated hypothermic machine perfusion prior to implantation and following a period of static cold storage does not improve graft survival or kidney function in kidneys retrieved from donors who are brain dead meeting the expanded donor criteria.

The objective of this study was to compare the effect of short-term oxygenated hypothermic machine perfusion preservation (end-HMPo2) after SCS vs SCS alone on 1-year graft survival in expanded criteria donor kidneys from donors who are brain dead.

In a prospective, randomized, multicenter trial, kidneys from expanded criteria donors were randomized to either SCS alone or SCS followed by end-HMPo2 prior to implantation with a minimum machine perfusion time of 120 minutes.

Centers in 5 European countries randomized 305 kidneys, of which 262 kidneys were successfully transplanted.

--Median cold ischemia time was 13.2 hours in the end-HMPo2 group and 12.9 hours in the SCS group; median duration in the end-HMPo2 group was 4.7 hours.

--One-year graft survival was 92.1% in the end-HMPo2 group vs 93.3% in the SCS group.

--The secondary endpoint analysis showed no significant between-group differences for delayed graft function, primary nonfunction, estimated glomerular filtration rate, and acute rejection.

Conclusively, reconditioning of expanded criteria donor kidneys from donors who are brain dead using end-HMPo2 after SCS does not improve graft survival or function compared with SCS alone.

Source: https://jamanetwork.com/journals/jamasurgery/article-abstract/2778929
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