Use of perfusion parameters in predicting outcomes of machine-preserved kidneys
Section snippets
Materials and methods
Data were analyzed from 332 consecutive kidneys machine preserved on the Waters RM-3 apparatus using Belzer-MP perfusate during January 2002 to July 2004. Criteria for machine perfusion at our center were: age ≥60 or age 50 to 59 with minimum one of the following: HTN, diabetes, admission serum creatinine ≥ 1.5, estimated GFR <70 mL/min, or doubling of serum creatinine (admit to last), and kidneys donated after cardiac death. Pump pressures were set at 60 mm Hg and allowed to decrease. Renal
Results
During the study period, 1356 kidneys were procured, of which 332 were preserved by pulsatile hypothermic perfusion using the Waters apparatus. Overall, 254 kidneys were transplanted with an immediate function rate of 65%. Seventy-eight kidneys were discarded (23.5%) with 43 of these having “poor perfusion parameters” as part of the reason for discard. Thirty-nine kidneys were removed from the pump in less than 4 hours—28 were transplanted and 11 were discarded. In 6 of the 11 discards “poor”
Discussion
Machine perfusion of deceased donor kidneys in the United States has regained wider acceptance in recent years, with the increasing kidney recovery from the extended criteria donor and increasing frequency of donation after cardiac death. The percentage of extended criteria donor kidneys increased nationally from 21.2% in 2002 to 26.4% in 2003.1 We use machine perfusion for all extended criteria donor kidneys and all kidneys retreived from donors after cardiac death. Our overall kidney discard
Acknowledgments
The authors gratefully acknowledge the excellent assistance of Ms. Gwendolyn Blakemore in the management of the renal perfusion database utilized in this report.
References (3)
- OPTN/SRTR data, presented to UNOS Organ Availability Committee, 2004 (unpublished...
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