Effect of Hypothermic Machine Perfusion on the Preservation of Kidneys Donated After Cardiac Death: A Single-Center, Randomized, Controlled Trial.
Wang W, Xie D, et al.Artificial Organs 2017; 08: 08.
Aims
To examine the effect of a hypothermic machine perfusion device (LifePort) in kidney transplantation from donation after cardiac death (DCD) donors.
Interventions
Paired kidneys from the same donor were randomly divided to receive either hypothermic machine perfusion (HMP) or common cold preservation (CCP).
Participants
24 pairs of DCD kidneys (donated from 18 men and 6 women, with an average age of 48.2 ± 12.6 years).
Outcomes
Outcomes measured included delayed graft function, acute rejection, pathological changes, serum creatinine at discharge and 6-months, mean urinary production and mean hospital stay.
Follow-up
6 months
CET Conclusions
This is generally a well conducted study with some good features. However, several larger, and better quality trials have been published in recent years addressing the same research question. There was no power calculation for this study, and as such it is small. It did however have enough power to show a significant reduction in DGF when HMP was used for DCD kidneys (from 37.5% to 16.7%). The overall rate of DGF was low, which may be related to the short cold ischaemic times of only 1-8 hours. The study used paired kidneys, which is a strength. However, kidneys could change randomisation allocation if they did not have a suitable patch or anatomy and the number of such kidneys is not presented in the paper. The method of randomisation is not described. Related to the reduced DGF was a shorter hospital stay for the recipient when HMP was used, and a lower serum creatinine on discharge. There were no other significant differences in the clinical outcomes reported.
Data analysis
Per protocol analysis
Trial registration
None