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A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation
Hypothermic machine perfusion (HMP) has been introduced as an alternative to static cold storage (SCS) in kidney transplantation, but its true benefit in the clinical routine remains incompletely understood. The aim of this study was to assess the effect of HMP vs. SCS in kidney transplantation. All...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408946/ https://www.ncbi.nlm.nih.gov/pubmed/32708180 http://dx.doi.org/10.3390/jcm9072311 |
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author | Gasteiger, Silvia Berchtold, Valeria Bösmüller, Claudia Dostal, Lucie Ulmer, Hanno Bogensperger, Christina Resch, Thomas Rudnicki, Michael Neuwirt, Hannes Oberhuber, Rupert Cardini, Benno Scheidl, Stefan Mayer, Gert Öfner, Dietmar Weissenbacher, Annemarie Schneeberger, Stefan |
author_facet | Gasteiger, Silvia Berchtold, Valeria Bösmüller, Claudia Dostal, Lucie Ulmer, Hanno Bogensperger, Christina Resch, Thomas Rudnicki, Michael Neuwirt, Hannes Oberhuber, Rupert Cardini, Benno Scheidl, Stefan Mayer, Gert Öfner, Dietmar Weissenbacher, Annemarie Schneeberger, Stefan |
author_sort | Gasteiger, Silvia |
collection | PubMed |
description | Hypothermic machine perfusion (HMP) has been introduced as an alternative to static cold storage (SCS) in kidney transplantation, but its true benefit in the clinical routine remains incompletely understood. The aim of this study was to assess the effect of HMP vs. SCS in kidney transplantation. All kidney transplants performed between 08/2015 and 12/2019 (n = 347) were propensity score (PS) matched for cold ischemia time (CIT), extended criteria donor (ECD), gender mismatch, cytomegalovirus (CMV) mismatch, re-transplantation and Eurotransplant (ET) senior program. A total of 103 HMP and 103 SCS instances fitted the matching criteria. Prior to PS matching, the CIT was longer in the HMP group (17.5 h vs. 13.3 h; p < 0.001), while the delayed graft function (DGF) rates were 29.8% and 32.3% in HMP and SCS, respectively. In the PS matched groups, the DGF rate was 64.1% in SCS vs. 31.1% following HMP: equivalent to a 51.5% reduction of the DGF rate (OR 0.485, 95% CI 0.318–0.740). DGF was associated with decreased 1- and 3-year graft survival (100% and 96.3% vs. 90.8% and 86.7%, p = 0.001 and p = 0.008) or a 4.1-fold increased risk of graft failure (HR = 4.108; 95% CI: 1.336–12.631; p = 0.014). HMP significantly reduces DGF in kidney transplantation. DGF remains a strong predictor of graft survival. |
format | Online Article Text |
id | pubmed-7408946 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-74089462020-08-13 A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation Gasteiger, Silvia Berchtold, Valeria Bösmüller, Claudia Dostal, Lucie Ulmer, Hanno Bogensperger, Christina Resch, Thomas Rudnicki, Michael Neuwirt, Hannes Oberhuber, Rupert Cardini, Benno Scheidl, Stefan Mayer, Gert Öfner, Dietmar Weissenbacher, Annemarie Schneeberger, Stefan J Clin Med Article Hypothermic machine perfusion (HMP) has been introduced as an alternative to static cold storage (SCS) in kidney transplantation, but its true benefit in the clinical routine remains incompletely understood. The aim of this study was to assess the effect of HMP vs. SCS in kidney transplantation. All kidney transplants performed between 08/2015 and 12/2019 (n = 347) were propensity score (PS) matched for cold ischemia time (CIT), extended criteria donor (ECD), gender mismatch, cytomegalovirus (CMV) mismatch, re-transplantation and Eurotransplant (ET) senior program. A total of 103 HMP and 103 SCS instances fitted the matching criteria. Prior to PS matching, the CIT was longer in the HMP group (17.5 h vs. 13.3 h; p < 0.001), while the delayed graft function (DGF) rates were 29.8% and 32.3% in HMP and SCS, respectively. In the PS matched groups, the DGF rate was 64.1% in SCS vs. 31.1% following HMP: equivalent to a 51.5% reduction of the DGF rate (OR 0.485, 95% CI 0.318–0.740). DGF was associated with decreased 1- and 3-year graft survival (100% and 96.3% vs. 90.8% and 86.7%, p = 0.001 and p = 0.008) or a 4.1-fold increased risk of graft failure (HR = 4.108; 95% CI: 1.336–12.631; p = 0.014). HMP significantly reduces DGF in kidney transplantation. DGF remains a strong predictor of graft survival. MDPI 2020-07-21 /pmc/articles/PMC7408946/ /pubmed/32708180 http://dx.doi.org/10.3390/jcm9072311 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gasteiger, Silvia Berchtold, Valeria Bösmüller, Claudia Dostal, Lucie Ulmer, Hanno Bogensperger, Christina Resch, Thomas Rudnicki, Michael Neuwirt, Hannes Oberhuber, Rupert Cardini, Benno Scheidl, Stefan Mayer, Gert Öfner, Dietmar Weissenbacher, Annemarie Schneeberger, Stefan A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation |
title | A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation |
title_full | A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation |
title_fullStr | A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation |
title_full_unstemmed | A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation |
title_short | A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation |
title_sort | retrospective propensity score matched analysis reveals superiority of hypothermic machine perfusion over static cold storage in deceased donor kidney transplantation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408946/ https://www.ncbi.nlm.nih.gov/pubmed/32708180 http://dx.doi.org/10.3390/jcm9072311 |
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