Machine Perfusion Better for Allografts

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Preserving renal allografts using machine perfusion (MP) rather than cold storage is associated with significantly better graft survival and reduced likelihood of returning to hemodialysis, according to researchers.


A team at WarsawMedicalUniversity in Poland retrospectively analyzed data on 415 renal allografts, of which 227 were MP-stored prior to transplantation. The other 188 kidneys were preserved by cold storage and served as controls. The organs were not randomized to MP or cold storage.


The five-year graft survival was 68.2% for the MP-stored kidneys compared with 54.2% for the cold storage kidneys, the authors reported in the American Journal of Transplantation (2007;7:1942-1947). Five years after transplantation, recipients of cold storage kidneys returned to hemodialysis almost twice as frequently as recipients of MP-stored kidneys (36% vs. 20%).


After controlling for the influence of short-term graft performance (acute rejection), MP significant decreased the likelihood of return to hemodialysis by 53%.


Five years following transplantation, the proportion of patients with a creatinine level below 2 mg/dL was 63% in the MP group compared with 45.7% in the CS group. Mortality was not significantly different between the MP and CS groups (16.5% and 17%, respectively) at five years.


The incidence of delayed graft function was similar for the MP and CS kidneys despite longer preservation times for the MP kidneys, the investigators noted.

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