Abstract: SA-PO089
Impact of Machine Perfusion on Delayed Graft Function and Graft Survival from High-Risk Donors
Session Information
- Transplantation: Recipient and Donor Assessment
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Andrade, Larissa Guedes da fonte, Universidade Federal de Pernambuco, Recife, Brazil
- Cavalcanti, Frederico Castelo Branco, Universidade Federal de Pernambuco, Recife, Brazil
- Valente, Lucila Maria, Universidade Federal de Pernambuco, Recife, Brazil
Background
After kidney transplantation(KT), graft may not function immediately and patient needs to undergo dialysis, characterizing delayed graft function (DGF). DGF increases length of hospital stay (LHS), costs and reduces graft survival (GS). DGF incidence is higher in expanded criteria donor (ECD), prolonged cold ischemia time (CIT) and donors with renal dysfunction. Machine perfusion (MP) is a method of preservation that can reduce DGF incidence. We analyzed DGF incidence, its duration, CIT, LHS, 1-year graft and patient survival and renal function estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) at 1, 3, 6, 9 and 12 months in KT with CS compared to MP after CS.
Methods
Retrospective cohort, in a single center. We included KT from DCE or standard deceased donors if CIT ≥ 24 hours, cardiorespiratory arrest before donation or creatinine ≥1.8mg/dL prior to retrieval from January 2015 to December 2016, 1-year follow up.
Results
Sample was 92 patients, 52 in MP group. Differences between groups were: age of recipient higher in MP group and donor creatinine prior to retrieval 0.7mg/dL higher in CS group. DGF incidence was 86.5% in MP group and 95% in CS group, p=0.29. There were no differences in DGF duration or LHS. CIT was 8.19 hours higher in the MP group, p<0.01. GS was 90.4% in the MP group and 87.5% in CS group. Patient survival was 94.2% in MP group and 95% in CS group. There were no differences in CKD-EPI at 1, 3, 6, 9 and 12 months. After 1-year KT, 89.6% of MP group and 66.7% of CS group had CKD-EPI higher than 30mL/min/1.73m2, p=0.01. In multivariate analysis, risk factors for worse 1-year graft function were: donor age (OR 1.11 CI95% 1.01-1.22; p=0,03) and CS preservation (OR 6.52 CI 95% 1.46-29.08; p=0.01).
Conclusion
The higher CIT in MP group did not increase incidence of DGF. 1-year graft function were better in MP preservation.