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/11449/162759 |
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 m(2) vs 49.0 +/- 26.9 mL/min per 1.73 m(2); 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 m(2); 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 m(2) vs 49.0 +/- 26.9 mL/min per 1.73 m(2); 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 m(2); 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.Univ Fed Sao Paulo, Hosp Rim, Sao Paulo, SP, BrazilOrg Procura Orgaos, Escola Paulista Med, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Hosp Clin, Sao Paulo, SP, BrazilHosp Israelita Albert Einstein, Kidney Transplant Unit, Sao Paulo, SP, BrazilHosp Samaritano, Sao Paulo, SP, BrazilSanta Casa Sao Paulo, Sao Paulo, SP, BrazilHosp Bandeirantes, Sao Paulo, SP, BrazilHosp Servidor Publ Estadual, Sao Paulo, SP, BrazilHosp Beneficencia Portuguesa, Sao Paulo, SP, BrazilHosp Dante Pazzanese, Sao Paulo, SP, BrazilHosp Base Sao Jose do Rio Preto, Sao Jose Do Rio Preto, SP, BrazilUniv Estadual Paulista, UNESP, Dept Internal Med, Rubiao Jr S-N, Sao Paulo, BrazilSanta Casa Ribeirao Preto, Ribeirao Preto, SP, BrazilHosp Alemao Oswaldo Cruz, Sao Paulo, SP, BrazilHosp Santa Marcelina, Sao Paulo, SP, BrazilUniv Estadual Paulista, UNESP, Dept Internal Med, Rubiao Jr S-N, Sao Paulo, BrazilLippincott Williams & WilkinsUniversidade Federal de São Paulo (UNIFESP)Universidade de São Paulo (USP)Hosp Israelita Albert EinsteinHosp SamaritanoSanta Casa Sao PauloHosp BandeirantesHosp Servidor Publ EstadualHosp Beneficencia PortuguesaHosp Dante PazzaneseHosp Base Sao Jose do Rio PretoUniversidade Estadual Paulista (Unesp)Santa Casa Ribeirao PretoHosp Alemao Oswaldo CruzHosp Santa MarcelinaTedesco-Silva Junior, HelioMello Offerni, Juliano ChrystianCarneiro, Vanessa AyresPaula, Mayara Ivani deNeto, Elias DavidCarvalhinho Lemos, Francine BrambateRequiao Moura, Lucio RobertoPacheco e Silva Filho, AlvaroMorais Cunha, Mirian de Fatima deSilva, Erica Francisco daMiorin, Luiz AntonioDemetrio, Daniela PriscilaLuconi, Paulo SergioSilva Luconi, Waldere Tania daBobbio, Savina AdrianaKuschnaroff, Liz MilsteinNoronha, Irene LourdesBraga, Sibele LessaBarsante, Renata CristinaMendes Moreira, Joao CezarMaximina Fernandes-Charpiot, Ida MariaAbbud-Filho, MarioModelli de Andrade, Luis Gustavo [UNESP]Garcia, Paula Dalsoglio [UNESP]Santamaria Saber, Luciana TanajuraLaurindo, Alan FernandesChocair, Pedro RenatoCuvello Neto, Americo LourencoZanocco, Juliana AparecidaAlmeida Soares Filho, Antonio Jose Duboc deAguiar, Wilson FerreiraPestana, Jose Medina2018-11-26T17:29:49Z2018-11-26T17:29:49Z2017-05-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article8application/pdfhttp://dx.doi.org/10.1097/TXD.0000000000000672Transplantation Direct. Philadelphia: Lippincott Williams & Wilkins, v. 3, n. 5, 8 p., 2017.2373-8731http://hdl.handle.net/11449/16275910.1097/TXD.0000000000000672WOS:000400508600006WOS000400508600006.pdfWeb of Sciencereponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengTransplantation Directinfo:eu-repo/semantics/openAccess2024-08-14T17:22:14Zoai:repositorio.unesp.br:11449/162759Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T17:22:14Repositório 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 Junior, 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 Junior, Helio |
author_facet |
Tedesco-Silva Junior, Helio Mello Offerni, Juliano Chrystian Carneiro, Vanessa Ayres Paula, Mayara Ivani de Neto, Elias David Carvalhinho Lemos, Francine Brambate Requiao Moura, Lucio Roberto Pacheco e Silva Filho, Alvaro Morais Cunha, Mirian de Fatima de Silva, Erica Francisco da Miorin, Luiz Antonio Demetrio, Daniela Priscila Luconi, Paulo Sergio Silva Luconi, Waldere Tania da Bobbio, Savina Adriana Kuschnaroff, Liz Milstein Noronha, Irene Lourdes Braga, Sibele Lessa Barsante, Renata Cristina Mendes Moreira, Joao Cezar Maximina Fernandes-Charpiot, Ida Maria Abbud-Filho, Mario Modelli de Andrade, Luis Gustavo [UNESP] Garcia, Paula Dalsoglio [UNESP] Santamaria Saber, Luciana Tanajura Laurindo, Alan Fernandes Chocair, Pedro Renato Cuvello Neto, Americo Lourenco Zanocco, Juliana Aparecida Almeida Soares Filho, Antonio Jose Duboc de Aguiar, Wilson Ferreira Pestana, Jose Medina |
author_role |
author |
author2 |
Mello Offerni, Juliano Chrystian Carneiro, Vanessa Ayres Paula, Mayara Ivani de Neto, Elias David Carvalhinho Lemos, Francine Brambate Requiao Moura, Lucio Roberto Pacheco e Silva Filho, Alvaro Morais Cunha, Mirian de Fatima de Silva, Erica Francisco da Miorin, Luiz Antonio Demetrio, Daniela Priscila Luconi, Paulo Sergio Silva Luconi, Waldere Tania da Bobbio, Savina Adriana Kuschnaroff, Liz Milstein Noronha, Irene Lourdes Braga, Sibele Lessa Barsante, Renata Cristina Mendes Moreira, Joao Cezar Maximina Fernandes-Charpiot, Ida Maria Abbud-Filho, Mario Modelli de Andrade, Luis Gustavo [UNESP] Garcia, Paula Dalsoglio [UNESP] Santamaria Saber, Luciana Tanajura Laurindo, Alan Fernandes Chocair, Pedro Renato Cuvello Neto, Americo Lourenco Zanocco, Juliana Aparecida Almeida Soares Filho, Antonio Jose Duboc de 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) Universidade de São Paulo (USP) Hosp Israelita Albert Einstein Hosp Samaritano Santa Casa Sao Paulo Hosp Bandeirantes Hosp Servidor Publ Estadual Hosp Beneficencia Portuguesa Hosp Dante Pazzanese Hosp Base Sao Jose do Rio Preto Universidade Estadual Paulista (Unesp) Santa Casa Ribeirao Preto Hosp Alemao Oswaldo Cruz Hosp Santa Marcelina |
dc.contributor.author.fl_str_mv |
Tedesco-Silva Junior, Helio Mello Offerni, Juliano Chrystian Carneiro, Vanessa Ayres Paula, Mayara Ivani de Neto, Elias David Carvalhinho Lemos, Francine Brambate Requiao Moura, Lucio Roberto Pacheco e Silva Filho, Alvaro Morais Cunha, Mirian de Fatima de Silva, Erica Francisco da Miorin, Luiz Antonio Demetrio, Daniela Priscila Luconi, Paulo Sergio Silva Luconi, Waldere Tania da Bobbio, Savina Adriana Kuschnaroff, Liz Milstein Noronha, Irene Lourdes Braga, Sibele Lessa Barsante, Renata Cristina Mendes Moreira, Joao Cezar Maximina Fernandes-Charpiot, Ida Maria Abbud-Filho, Mario Modelli de Andrade, Luis Gustavo [UNESP] Garcia, Paula Dalsoglio [UNESP] Santamaria Saber, Luciana Tanajura Laurindo, Alan Fernandes Chocair, Pedro Renato Cuvello Neto, Americo Lourenco Zanocco, Juliana Aparecida Almeida Soares Filho, Antonio Jose Duboc de 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 m(2) vs 49.0 +/- 26.9 mL/min per 1.73 m(2); 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 m(2); 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 2018-11-26T17:29:49Z 2018-11-26T17:29:49Z |
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. Philadelphia: Lippincott Williams & Wilkins, v. 3, n. 5, 8 p., 2017. 2373-8731 http://hdl.handle.net/11449/162759 10.1097/TXD.0000000000000672 WOS:000400508600006 WOS000400508600006.pdf |
url |
http://dx.doi.org/10.1097/TXD.0000000000000672 http://hdl.handle.net/11449/162759 |
identifier_str_mv |
Transplantation Direct. Philadelphia: Lippincott Williams & Wilkins, v. 3, n. 5, 8 p., 2017. 2373-8731 10.1097/TXD.0000000000000672 WOS:000400508600006 WOS000400508600006.pdf |
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.format.none.fl_str_mv |
8 application/pdf |
dc.publisher.none.fl_str_mv |
Lippincott Williams & Wilkins |
publisher.none.fl_str_mv |
Lippincott Williams & Wilkins |
dc.source.none.fl_str_mv |
Web of Science 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_ |
1808128113568120832 |