Machine Perfusion versus Cold Storage for the Preservation of Kidneys from Donors >=65 Years Allocated in the Eurotransplant Senior Programme.
Gallinat A, Moers C, et al.Nephrology Dialysis Transplantation [record in progress].
Aims
To explore whether kidneys preserved by hypothermic machine perfusion would confer better results of transplantation in the Eurotransplant Senior Programme (ESP) compared with simple cold storage.
Interventions
Kidneys preserved by cold storage versus machine perfusion from organ procurement until transplantation.
Participants
85 deceased heart-beating donors over 65 years old.
Outcomes
The primary endpoint was delayed graft function (DGF). The secondary endpoints were functional DGF, primary non-function, episodes of acute rejection and 1-year graft and patient survival rates.
Follow-up
1 year post-transplant
CET Conclusions
In this extension of the Eurotransplant machine perfusion trial, results from the Eurotransplant Senior Program (ESP) are assessed. Kidneys from donors over 65 years allocated to recipients over 65 years were randomised to machine perfusion or static cold storage in a paired fashion. There was no statistically significant difference in delayed graft function, acute rejection or graft survival. Static cold storage was associated with a statistically significant increase in primary non-function. Possibly the sample size needed to be larger given an overestimation of delayed graft function rates for cold storage in the power calculation. The low delayed graft function rate in the study is explained by the authors as arising from the exclusion of high risk donors from whom one or more kidneys were rejected. However, this is at odds with the unexpectedly high rate of primary non-function.
Data analysis
Per protocol analysis
Quality notes
This paper reported the same trial of the publication: Moers C, Smits JM, Maathuis MH, et al. Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med, 2009; 360: 7–19. The methodological quality assessment was based on the article by Moers et al.
Trial registration
Not reported