OPTIMIZING IMMEDIATE GRAFT FUNCTION IN KIDNEY TRANSPLANTATION

T.B. Mcgregor¹, V. Bathini¹, V. Mcalister¹, P. Luke², A. Sener^2
1Transplant, University of Western, London/CANADA, ²Surgery, University of Western Ontario, london/CANADA

Body: Introduction : The use of a renal perfusion pump vs. cold storage for the preservation of kidneys obtained from donors after cardiac death (DCD) is controversial. Herein, we examine the impact of using renal perfusion pumps on delayed graft function and graft survival using a systematic review. Methods : The PUBMED database was searched and reference lists from 1960 to 2009 were consulted. Randomized controlled trials as well as prospective and retrospective cohort studies that compared delayed graft function and graft survival were included. Studies excluded from review were unable to discriminate between DCD and neurologically deceased donor (NDD) deaths. Eleven studies that followed a total of 3377 participants qualified for review. Statistical analysis was carried out using the random effects criteria and odds ratios calculated using the Cochrane database software. Results : We found that perfusion pumped kidneys from DCD donors had reduced DGF rates vs. kidneys that were placed in cold storage (Figure 1: p=0.008; odds ratio 0.4, CI 0.20-0.82). In addition, graft function at 1 year post-transplantation favored perfusion pumped kidneys (p=0.04, odds ratio 1.96, CI 1.02-3.77). No differences in primary non-function rates between groups were noted. Conclusion : This review supports the use of perfusion pumps for DCD kidney transplantation with respect to delayed graft function rates and graft survival.

Disclosure: All authors have declared no conflicts of interest.