Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death?
Background. Hypothermic machine perfusion (HMP) reduces renal injury in donation after circulatory death donors with a high Kidney Donor Profile Index (KDPI). This study aims to characterize the correlation between KDPI, HMP parameters, and donor vitals during the withdrawal period in predicting sho...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2024-04-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001601 |
| _version_ | 1797243090771116032 |
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| author | Juliano C. M. Offerni, MD Erica Ai Li Danny Matti, MD Grant Luke, BSc Patrick P. Luke, MD Alp Sener, MD, PhD |
| author_facet | Juliano C. M. Offerni, MD Erica Ai Li Danny Matti, MD Grant Luke, BSc Patrick P. Luke, MD Alp Sener, MD, PhD |
| author_sort | Juliano C. M. Offerni, MD |
| collection | DOAJ |
| description | Background. Hypothermic machine perfusion (HMP) reduces renal injury in donation after circulatory death donors with a high Kidney Donor Profile Index (KDPI). This study aims to characterize the correlation between KDPI, HMP parameters, and donor vitals during the withdrawal period in predicting short- and long-term graft outcomes.
Methods. ANOVA with Tukey’s honestly significant difference tests compared the relationship between average flow, average resistance, peak resistance, flow slope, and resistance slope on day 30, 1-y, and 3-y eGFR, and days of delayed graft function. Graft and recipient survival rates were assessed using Kaplan-Meier analysis.
Results. The data for 72 grafts were suitable for analysis. Kidneys with KDPI >50% had a significantly higher day 30, and 1-y posttransplant eGFR, if HMP average flow was >150 mL/min, or the average resistance was <0.15 mm Hg/mL/min, compared with kidneys with also KDPI >50% but had not achieved the same pump parameters. There were no significant differences in the Kaplan-Meier analysis, considering recipient or graft survival, regardless of the KPDI score with 3- or 5-y outcomes.
Conclusions. Use of average resistance and average flow from a HMP, in conjunction with KDPI, may be predictive of the short- and long-term function of donation after circulatory death kidney transplants. |
| first_indexed | 2024-04-24T18:49:35Z |
| format | Article |
| id | doaj.art-72b0750444ec4b26887dd19b19e437ac |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-04-24T18:49:35Z |
| publishDate | 2024-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-72b0750444ec4b26887dd19b19e437ac2024-03-27T03:43:30ZengWolters KluwerTransplantation Direct2373-87312024-04-01104e160110.1097/TXD.0000000000001601202404000-00002Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death?Juliano C. M. Offerni, MD0Erica Ai Li1Danny Matti, MD2Grant Luke, BSc3Patrick P. Luke, MD4Alp Sener, MD, PhD51 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.Background. Hypothermic machine perfusion (HMP) reduces renal injury in donation after circulatory death donors with a high Kidney Donor Profile Index (KDPI). This study aims to characterize the correlation between KDPI, HMP parameters, and donor vitals during the withdrawal period in predicting short- and long-term graft outcomes. Methods. ANOVA with Tukey’s honestly significant difference tests compared the relationship between average flow, average resistance, peak resistance, flow slope, and resistance slope on day 30, 1-y, and 3-y eGFR, and days of delayed graft function. Graft and recipient survival rates were assessed using Kaplan-Meier analysis. Results. The data for 72 grafts were suitable for analysis. Kidneys with KDPI >50% had a significantly higher day 30, and 1-y posttransplant eGFR, if HMP average flow was >150 mL/min, or the average resistance was <0.15 mm Hg/mL/min, compared with kidneys with also KDPI >50% but had not achieved the same pump parameters. There were no significant differences in the Kaplan-Meier analysis, considering recipient or graft survival, regardless of the KPDI score with 3- or 5-y outcomes. Conclusions. Use of average resistance and average flow from a HMP, in conjunction with KDPI, may be predictive of the short- and long-term function of donation after circulatory death kidney transplants.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001601 |
| spellingShingle | Juliano C. M. Offerni, MD Erica Ai Li Danny Matti, MD Grant Luke, BSc Patrick P. Luke, MD Alp Sener, MD, PhD Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death? Transplantation Direct |
| title | Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death? |
| title_full | Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death? |
| title_fullStr | Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death? |
| title_full_unstemmed | Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death? |
| title_short | Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death? |
| title_sort | can we predict kidney graft function and graft survival using hypothermic machine perfusion parameters from donors after circulatory death |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001601 |
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