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Foucher, Yohann; Fournier, Marie-Cécile; Legendre, Christophe; Morelon, Emmanuel; Buron, Fanny; Girerd, Sophie; Ladrière, Marc; Mourad, Georges; Garrigue, Valérie; Glotz, Denis; Lefaucheur, Carmen; Cassuto, Elisabeth; Albano, Laetitia; Giral, Magali; Dantal, Jacques; Hériot, Lyon E; Badet, Lionel; Maria Brunet, F B; Cahen, Rémi; Daoud, Sameh; Fournie, Coralie; Grégoire, Arnaud; Koenig, Alice; Charlène Lévi, E M; [...]

Comparison of machine perfusion versus cold storage in kidney transplant recipients from expanded criteria donors: a cohort-based study

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  • Media type: E-Article
  • Title: Comparison of machine perfusion versus cold storage in kidney transplant recipients from expanded criteria donors: a cohort-based study
  • Contributor: Foucher, Yohann; Fournier, Marie-Cécile; Legendre, Christophe; Morelon, Emmanuel; Buron, Fanny; Girerd, Sophie; Ladrière, Marc; Mourad, Georges; Garrigue, Valérie; Glotz, Denis; Lefaucheur, Carmen; Cassuto, Elisabeth; Albano, Laetitia; Giral, Magali; Dantal, Jacques; Hériot, Lyon E; Badet, Lionel; Maria Brunet, F B; Cahen, Rémi; Daoud, Sameh; Fournie, Coralie; Grégoire, Arnaud; Koenig, Alice; Charlène Lévi, E M; [...]
  • Published: Oxford University Press (OUP), 2020
  • Published in: Nephrology Dialysis Transplantation, 35 (2020) 6, Seite 1051-1059
  • Language: English
  • DOI: 10.1093/ndt/gfz175
  • ISSN: 0931-0509; 1460-2385
  • Keywords: Transplantation ; Nephrology
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Most studies comparing the efficacy of hypothermic machine perfusion (HMP) versus static cold storage (SCS) are based on short-term outcomes. We aimed to better evaluate the mid-term impact of HMP in patients receiving expanded criteria donor (ECD) kidneys.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The analyses were based on the French Données Informatisées et VAlidées en Transplantation (DIVAT) observational cohort. Patients aged ≥45 years transplanted for the first or second times from an ECD donor since 2010 were studied. Our study reported the graft and/or patient survivals and the incidence of acute rejection episode. The Cox models and the Kaplan–Meier estimators, weighted on the propensity score, were used to study the times-to-events.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among the 2019 included patients, 1073 were in the SCS group versus 946 in the HMP group. The mean life expectancy with functioning graft was 5.7 years [95% confidence interval (CI) 5.4–6.1] for the HMP cohort followed-up for 8 years post-transplantation versus 6.0 years (95% CI 5.7–6.2) for the SCS group. These mid-term results were comparable in the patients receiving grafts from donors aged ≥70 years and in the transplantations with cold ischaemia time ≥18 h.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Our study challenges the utility of using HMP to improve mid-term patient and graft survival. Nevertheless, the improvement of the short-term outcomes is indisputable. It is necessary to continue technological innovations to obtain long-term results.</jats:p></jats:sec>
  • Access State: Open Access