Lipid Peroxidation Products in Machine Perfusion of Older Donor Kidneys.
Nagelschmidt M, Minor T, et al.Journal of Surgical Research, [record in progress].
Aims
To identify the biomarkers in machine-perfused older donor kidneys that were associated with post-transplant outcomes in renal transplant recipients.
Interventions
Pulsatile machine perfusion.
Participants
111 machine-perfused kidneys recovered from donors who were aged 55 years or older.
Outcomes
Delayed graft function, primary non-function and graft failure; biomarkers measured in machine perfusate were: total glutathione (tGST), p-GST, a-GST, S-transferase, lipid peroxidation products, lactate dehydrogenase and lactate.
Follow-up
Not applicable
CET Conclusions
Donors of kidneys who were aged 55 years or more were considered as ECD donors. A number of biomarkers were measured in machine perfused kidneys that were part of the large randomised trial of machine perfusion versus cold solution and it was only the lipid peroxidation markers that proved to be independent predictors of delayed graft function after transplantation. However the association was modest and there is need for analysis of a much larger cohort, particularly with an adequate number of kidneys with primary nonfunction.
Data analysis
Per protocol analysis
Quality notes
This is a sub-group analysis of a previous publication of the same RCT: Moers C, Smits JM, Maathuis MH, et al. Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med 2009; 360:7. The methodological quality assessment was based on the previous publication.
Trial registration
ISRCTN 83876362 (ISRCTN)