Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1097/TXD.0000000000000672 http://hdl.handle.net/11449/240998 |
Resumo: | Background. This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). Methods. In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF. Secondary endpoints included the duration of DGF, hospital stay, primary nonfunction, estimated glomerular filtration rate, acute rejection, and allograft and patient survivals. Results. Mean cold ischemia time was high but not different between the 2 groups (25.6 ± 6.6 hours vs 25.05 ± 6.3 hours, 0.937). The incidence of DGF was lower in the machine perfusion compared with cold storage group (61% vs. 45%, P = 0.031). Machine perfusion was independently associated with a reduced risk of DGF (odds ratio, 0.49; 95% confidence interval, 0.26-0.95). Mean estimated glomerular filtration rate tended to be higher at day 28 (40.6 ± 19.9 mL/min per 1.73 m2 vs 49.0 ± 26.9 mL/min per 1.73 m2; P = 0.262) and 1 year (48.3 ± 19.8 mL/min per 1.73 m2 vs 54.4 ± 28.6 mL/min per 1.73 m2; P = 0.201) in the machine perfusion group. No differences in the incidence of acute rejection, primary nonfunction (0% vs 2.5%), graft loss (7.5% vs 10%), or death (8.8% vs 6.3%) were observed. Conclusions. In this cohort of recipients of deceased donor kidneys with high mean cold ischemia time and high incidence of DGF, the use of continuous machine perfusion was associated with a reduced risk of DGF compared with the traditional cold storage preservation method. |
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Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft FunctionBackground. This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). Methods. In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF. Secondary endpoints included the duration of DGF, hospital stay, primary nonfunction, estimated glomerular filtration rate, acute rejection, and allograft and patient survivals. Results. Mean cold ischemia time was high but not different between the 2 groups (25.6 ± 6.6 hours vs 25.05 ± 6.3 hours, 0.937). The incidence of DGF was lower in the machine perfusion compared with cold storage group (61% vs. 45%, P = 0.031). Machine perfusion was independently associated with a reduced risk of DGF (odds ratio, 0.49; 95% confidence interval, 0.26-0.95). Mean estimated glomerular filtration rate tended to be higher at day 28 (40.6 ± 19.9 mL/min per 1.73 m2 vs 49.0 ± 26.9 mL/min per 1.73 m2; P = 0.262) and 1 year (48.3 ± 19.8 mL/min per 1.73 m2 vs 54.4 ± 28.6 mL/min per 1.73 m2; P = 0.201) in the machine perfusion group. No differences in the incidence of acute rejection, primary nonfunction (0% vs 2.5%), graft loss (7.5% vs 10%), or death (8.8% vs 6.3%) were observed. Conclusions. In this cohort of recipients of deceased donor kidneys with high mean cold ischemia time and high incidence of DGF, the use of continuous machine perfusion was associated with a reduced risk of DGF compared with the traditional cold storage preservation method.Hospital do Rim Universidade Federal de São Paulo, SPOrganização de Procura de Orgãos Escola Paulista de Medicina, SPHospital das Clínicas da Faculdade de Medicina Universidade de São Paulo, SPKidney Transplant Unit Hospital Israelita Albert Einstein, SPHospital Samaritano, SPSanta Casa de São Paulo, SPHospital Bandeirantes, SPHospital do Servidor Público Estadual, SPHospital Beneficência Portuguesa, SPHospital Dante Pazzanese, SPHospital de Base de São José do Rio Preto, SPDepartment of Internal Medicine-UNESP Universidade Estadual Paulista, Rubião Jr, S/N, BotucatuSanta Casa de Ribeirão Preto, SPHospital Alemão Oswaldo Cruz, SPHospital Santa Marcelina, SPNephrology Division Hospital do Rim Universidade Federal de São Paulo, Rua Borges Lagoa, 960-11 AndarDepartment of Internal Medicine-UNESP Universidade Estadual Paulista, Rubião Jr, S/N, BotucatuUniversidade Federal de São Paulo (UNIFESP)Escola Paulista de MedicinaUniversidade de São Paulo (USP)Hospital Israelita Albert EinsteinHospital SamaritanoSanta Casa de São PauloHospital BandeirantesHospital do Servidor Público EstadualHospital Beneficência PortuguesaHospital Dante PazzaneseHospital de Base de São José do Rio PretoUniversidade Estadual Paulista (UNESP)Santa Casa de Ribeirão PretoHospital Alemão Oswaldo CruzHospital Santa MarcelinaTedesco-Silva, HelioOfferni, Juliano Chrystian MelloCarneiro, Vanessa AyresPaula, Mayara Ivani deDavid Neto, EliasLemos, Francine Brambate CarvalhinhoMoura, Lúcio Roberto RequiãoSilva Filho, Alvaro Pacheco eCunha, Mirian de Fátima de MoraisSilva, Erica Francisco daMiorin, Luiz AntonioDemetrio, Daniela PriscilaLuconi, Paulo SérgioLuconi, Waldere Tania da SilvaBobbio, Savina AdrianaKuschnaroff, Liz MilsteinNoronha, Irene LourdesBraga, Sibele LessaBarsante, Renata CristinaMoreira, João Cezar MendesFernandes-Charpiot, Ida Maria MaximinaAbbud-Filho, Mariode Andrade, Luis Gustavo Modelli [UNESP]Garcia, Paula Dalsoglio [UNESP]Saber, Luciana Tanajura SantamariaLaurindo, Alan FernandesChocair, Pedro RenatoNeto, Américo Lourenço CuvelloZanocco, Juliana Aparecidade Almeida Soares Filho, Antonio Jose DubocAguiar, Wilson FerreiraPestana, Jose Medina2023-03-01T20:42:25Z2023-03-01T20:42:25Z2017-05-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1097/TXD.0000000000000672Transplantation Direct, v. 3, n. 5, 2017.2373-8731http://hdl.handle.net/11449/24099810.1097/TXD.00000000000006722-s2.0-85130151638Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengTransplantation Directinfo:eu-repo/semantics/openAccess2023-03-01T20:42:26Zoai:repositorio.unesp.br:11449/240998Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462023-03-01T20:42:26Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function |
title |
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function |
spellingShingle |
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function Tedesco-Silva, Helio |
title_short |
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function |
title_full |
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function |
title_fullStr |
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function |
title_full_unstemmed |
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function |
title_sort |
Randomized Trial of Machine Perfusion Versus Cold Storage in Recipients of Deceased Donor Kidney Transplants with High Incidence of Delayed Graft Function |
author |
Tedesco-Silva, Helio |
author_facet |
Tedesco-Silva, Helio Offerni, Juliano Chrystian Mello Carneiro, Vanessa Ayres Paula, Mayara Ivani de David Neto, Elias Lemos, Francine Brambate Carvalhinho Moura, Lúcio Roberto Requião Silva Filho, Alvaro Pacheco e Cunha, Mirian de Fátima de Morais Silva, Erica Francisco da Miorin, Luiz Antonio Demetrio, Daniela Priscila Luconi, Paulo Sérgio Luconi, Waldere Tania da Silva Bobbio, Savina Adriana Kuschnaroff, Liz Milstein Noronha, Irene Lourdes Braga, Sibele Lessa Barsante, Renata Cristina Moreira, João Cezar Mendes Fernandes-Charpiot, Ida Maria Maximina Abbud-Filho, Mario de Andrade, Luis Gustavo Modelli [UNESP] Garcia, Paula Dalsoglio [UNESP] Saber, Luciana Tanajura Santamaria Laurindo, Alan Fernandes Chocair, Pedro Renato Neto, Américo Lourenço Cuvello Zanocco, Juliana Aparecida de Almeida Soares Filho, Antonio Jose Duboc Aguiar, Wilson Ferreira Pestana, Jose Medina |
author_role |
author |
author2 |
Offerni, Juliano Chrystian Mello Carneiro, Vanessa Ayres Paula, Mayara Ivani de David Neto, Elias Lemos, Francine Brambate Carvalhinho Moura, Lúcio Roberto Requião Silva Filho, Alvaro Pacheco e Cunha, Mirian de Fátima de Morais Silva, Erica Francisco da Miorin, Luiz Antonio Demetrio, Daniela Priscila Luconi, Paulo Sérgio Luconi, Waldere Tania da Silva Bobbio, Savina Adriana Kuschnaroff, Liz Milstein Noronha, Irene Lourdes Braga, Sibele Lessa Barsante, Renata Cristina Moreira, João Cezar Mendes Fernandes-Charpiot, Ida Maria Maximina Abbud-Filho, Mario de Andrade, Luis Gustavo Modelli [UNESP] Garcia, Paula Dalsoglio [UNESP] Saber, Luciana Tanajura Santamaria Laurindo, Alan Fernandes Chocair, Pedro Renato Neto, Américo Lourenço Cuvello Zanocco, Juliana Aparecida de Almeida Soares Filho, Antonio Jose Duboc Aguiar, Wilson Ferreira Pestana, Jose Medina |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Universidade de São Paulo (USP) Hospital Israelita Albert Einstein Hospital Samaritano Santa Casa de São Paulo Hospital Bandeirantes Hospital do Servidor Público Estadual Hospital Beneficência Portuguesa Hospital Dante Pazzanese Hospital de Base de São José do Rio Preto Universidade Estadual Paulista (UNESP) Santa Casa de Ribeirão Preto Hospital Alemão Oswaldo Cruz Hospital Santa Marcelina |
dc.contributor.author.fl_str_mv |
Tedesco-Silva, Helio Offerni, Juliano Chrystian Mello Carneiro, Vanessa Ayres Paula, Mayara Ivani de David Neto, Elias Lemos, Francine Brambate Carvalhinho Moura, Lúcio Roberto Requião Silva Filho, Alvaro Pacheco e Cunha, Mirian de Fátima de Morais Silva, Erica Francisco da Miorin, Luiz Antonio Demetrio, Daniela Priscila Luconi, Paulo Sérgio Luconi, Waldere Tania da Silva Bobbio, Savina Adriana Kuschnaroff, Liz Milstein Noronha, Irene Lourdes Braga, Sibele Lessa Barsante, Renata Cristina Moreira, João Cezar Mendes Fernandes-Charpiot, Ida Maria Maximina Abbud-Filho, Mario de Andrade, Luis Gustavo Modelli [UNESP] Garcia, Paula Dalsoglio [UNESP] Saber, Luciana Tanajura Santamaria Laurindo, Alan Fernandes Chocair, Pedro Renato Neto, Américo Lourenço Cuvello Zanocco, Juliana Aparecida de Almeida Soares Filho, Antonio Jose Duboc Aguiar, Wilson Ferreira Pestana, Jose Medina |
description |
Background. This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). Methods. In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF. Secondary endpoints included the duration of DGF, hospital stay, primary nonfunction, estimated glomerular filtration rate, acute rejection, and allograft and patient survivals. Results. Mean cold ischemia time was high but not different between the 2 groups (25.6 ± 6.6 hours vs 25.05 ± 6.3 hours, 0.937). The incidence of DGF was lower in the machine perfusion compared with cold storage group (61% vs. 45%, P = 0.031). Machine perfusion was independently associated with a reduced risk of DGF (odds ratio, 0.49; 95% confidence interval, 0.26-0.95). Mean estimated glomerular filtration rate tended to be higher at day 28 (40.6 ± 19.9 mL/min per 1.73 m2 vs 49.0 ± 26.9 mL/min per 1.73 m2; P = 0.262) and 1 year (48.3 ± 19.8 mL/min per 1.73 m2 vs 54.4 ± 28.6 mL/min per 1.73 m2; P = 0.201) in the machine perfusion group. No differences in the incidence of acute rejection, primary nonfunction (0% vs 2.5%), graft loss (7.5% vs 10%), or death (8.8% vs 6.3%) were observed. Conclusions. In this cohort of recipients of deceased donor kidneys with high mean cold ischemia time and high incidence of DGF, the use of continuous machine perfusion was associated with a reduced risk of DGF compared with the traditional cold storage preservation method. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-05-01 2023-03-01T20:42:25Z 2023-03-01T20:42:25Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1097/TXD.0000000000000672 Transplantation Direct, v. 3, n. 5, 2017. 2373-8731 http://hdl.handle.net/11449/240998 10.1097/TXD.0000000000000672 2-s2.0-85130151638 |
url |
http://dx.doi.org/10.1097/TXD.0000000000000672 http://hdl.handle.net/11449/240998 |
identifier_str_mv |
Transplantation Direct, v. 3, n. 5, 2017. 2373-8731 10.1097/TXD.0000000000000672 2-s2.0-85130151638 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Transplantation Direct |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1799965554786697216 |