Machine Perfusion Beats Cold Storage

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The process reduces the risk of delayed graft function in patients who receive deceased donor kidneys.

Hypothermic machine perfusion of deceased donor kidneys is associated with better transplantation outcomes than cold storage of the organs in the first year following the procedure, a study found.

In the study, Cyril Moers, MD, at University Medical Center Groningen in The Netherlands, and colleagues randomly assigned one kidney from 336 deceased donors to machine perfusion and the other to cold storage. The donors had a mean age of 51 years. The investigators followed all 672 recipients for one year. The primary end point was delayed graft function, defined as the need for dialysis in the first week after transplantation.

Delayed graft function developed in 70 patients (20.8%) in the machine-perfusion group compared with 89 who received the cold-storage kidneys (26.5%), the authors reported in The New England Journal of Medicine (2009;360:7-19). This difference translated into a significant 43% reduced risk of delayed graft function in machine-perfusion group, after adjusting for confounders.

Machine perfusion was associated with lower serum creatinine levels during the first two weeks following transplantation as well as a 48% reduced risk of graft failure. Furthermore, the machine-perfusion group had significantly better one-year allograft survival (94% vs. 90%). “No serious adverse events were directly attributable to machine perfusion,” the authors wrote.

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