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Initial experience with hypothermic machine perfusion of kidneys from deceased donors in the Uppsala region in Sweden

Sedigh, A ; Tufveson, G ; Bäckman, L ; Biglarnia, A-R LU orcid and Lorant, T (2013) In Transplantation Proceedings 45(3). p.71-1168
Abstract

BACKGROUND: Simple cold storage (CS) is the gold standard for organ preservation. Recently, evidence has been presented suggesting compared with CS hypothermic machine perfusion (HMP) improves the quality and outcome of kidneys for transplantation. Uppsala has used the LifePort Kidney Transporter to preserve deceased donor kidneys. We evaluated our first single-center 52 cases retrospectively.

METHODS: Deceased donor kidneys preserved with HMP between July 2010 and July 2012 (n = 52) were compared with a matched historical cohort of organs preserved by CS between January 2009 and July 2012 (n = 87). We evaluated delayed graft function (DGF), creatinine level at hospital discharge, length of hospital stay, incidence of acute... (More)

BACKGROUND: Simple cold storage (CS) is the gold standard for organ preservation. Recently, evidence has been presented suggesting compared with CS hypothermic machine perfusion (HMP) improves the quality and outcome of kidneys for transplantation. Uppsala has used the LifePort Kidney Transporter to preserve deceased donor kidneys. We evaluated our first single-center 52 cases retrospectively.

METHODS: Deceased donor kidneys preserved with HMP between July 2010 and July 2012 (n = 52) were compared with a matched historical cohort of organs preserved by CS between January 2009 and July 2012 (n = 87). We evaluated delayed graft function (DGF), creatinine level at hospital discharge, length of hospital stay, incidence of acute rejection episodes during the first year after transplantation, and graft survival.

RESULTS: Both groups included approximately 69% expanded criteria donors (ECD). Median cold ischemia time (CIT) was 12.8 hours in the HMP group and 11.7 hours in the CS group. The incidence of DGF was 11.5% with HMP and 20.7% with CS. Compared with CS, HMP significantly reduced the occurrence of DGF from 21.4% to 0% using standard criteria kidneys (P = .046), whereas the use of HMP did not impact the occurrence of DGF with ECD kidneys. The creatinine level at hospital discharge was lower after HMP than after CS (P = .047). No difference in graft survival was observed between the groups.

CONCLUSIONS: Machine perfusion resulted in a lower occurrence of DGF using kidneys from standard criteria donors with a lower creatinine at hospital discharge among the cohort with reasonably low CIT. Using machine perfusion seems to be safe; no adverse surgical events occurred during the study period.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Adolescent, Adult, Aged, Cadaver, Cohort Studies, Female, Humans, Male, Middle Aged, Perfusion, Sweden, Tissue Donors, Young Adult
in
Transplantation Proceedings
volume
45
issue
3
pages
71 - 1168
publisher
Elsevier
external identifiers
  • pmid:23622652
  • scopus:84876880760
ISSN
0041-1345
DOI
10.1016/j.transproceed.2012.10.017
language
English
LU publication?
no
additional info
Copyright © 2013 Elsevier Inc. All rights reserved.
id
0dd25a9a-3572-4e93-b91a-938553fe8126
date added to LUP
2025-12-17 14:15:13
date last changed
2025-12-19 02:25:41
@article{0dd25a9a-3572-4e93-b91a-938553fe8126,
  abstract     = {{<p>BACKGROUND: Simple cold storage (CS) is the gold standard for organ preservation. Recently, evidence has been presented suggesting compared with CS hypothermic machine perfusion (HMP) improves the quality and outcome of kidneys for transplantation. Uppsala has used the LifePort Kidney Transporter to preserve deceased donor kidneys. We evaluated our first single-center 52 cases retrospectively.</p><p>METHODS: Deceased donor kidneys preserved with HMP between July 2010 and July 2012 (n = 52) were compared with a matched historical cohort of organs preserved by CS between January 2009 and July 2012 (n = 87). We evaluated delayed graft function (DGF), creatinine level at hospital discharge, length of hospital stay, incidence of acute rejection episodes during the first year after transplantation, and graft survival.</p><p>RESULTS: Both groups included approximately 69% expanded criteria donors (ECD). Median cold ischemia time (CIT) was 12.8 hours in the HMP group and 11.7 hours in the CS group. The incidence of DGF was 11.5% with HMP and 20.7% with CS. Compared with CS, HMP significantly reduced the occurrence of DGF from 21.4% to 0% using standard criteria kidneys (P = .046), whereas the use of HMP did not impact the occurrence of DGF with ECD kidneys. The creatinine level at hospital discharge was lower after HMP than after CS (P = .047). No difference in graft survival was observed between the groups.</p><p>CONCLUSIONS: Machine perfusion resulted in a lower occurrence of DGF using kidneys from standard criteria donors with a lower creatinine at hospital discharge among the cohort with reasonably low CIT. Using machine perfusion seems to be safe; no adverse surgical events occurred during the study period.</p>}},
  author       = {{Sedigh, A and Tufveson, G and Bäckman, L and Biglarnia, A-R and Lorant, T}},
  issn         = {{0041-1345}},
  keywords     = {{Adolescent; Adult; Aged; Cadaver; Cohort Studies; Female; Humans; Male; Middle Aged; Perfusion; Sweden; Tissue Donors; Young Adult}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{71--1168}},
  publisher    = {{Elsevier}},
  series       = {{Transplantation Proceedings}},
  title        = {{Initial experience with hypothermic machine perfusion of kidneys from deceased donors in the Uppsala region in Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.transproceed.2012.10.017}},
  doi          = {{10.1016/j.transproceed.2012.10.017}},
  volume       = {{45}},
  year         = {{2013}},
}