PLoS ONE (Jan 2024)

The impact of preservation solutions for static cold storage on kidney transplantation outcomes: Results of a Brazilian nationwide multicenter study.

  • Tainá Veras de Sandes-Freitas,
  • Lucio Requião Moura,
  • Deise Rosa de Boni Monteiro de Carvalho,
  • Valter Duro Garcia,
  • Luis Gustavo Modelli de Andrade,
  • Marilda Mazzali,
  • Roberto Ceratti Manfro,
  • Luciane Mônica Deboni,
  • Elias Davi-Neto,
  • Claudia Maria Costa de Oliveira,
  • Frederico Castelo Branco Cavalcanti,
  • Rafael Lage Madeira,
  • Ronaldo de Matos Esmeraldo,
  • Denise Rodrigues Simão,
  • Ana Carolina Guedes Meira,
  • Gustavo Fernandes Ferreira,
  • Marcus Lasmar,
  • Alexandre Tortoza Bignelli,
  • Alvaro Pacheco-Silva,
  • José Medina Pestana,
  • Hélio Tedesco Silva,
  • DGF-Brazil Study Group

DOI
https://doi.org/10.1371/journal.pone.0306056
Journal volume & issue
Vol. 19, no. 7
p. e0306056

Abstract

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This study evaluated the current practices of selecting cold storage preservation solutions in Brazil and their impact on delayed graft function (DGF) incidence and 1-year outcomes in kidney transplant recipients. A retrospective cohort study was conducted, including 3,134 brain-dead deceased donor kidney transplants performed between 2014 and 2015 in 18 Brazilian centers. The most commonly used preservation solution was Euro-collins (EC, 55.4%), followed by Histidine-tryptophan-ketoglutarate (HTK, 30%) and Institut Georges Lopez (IGL-1, 14.6%). The incidence of DGF was 54.4%, with 11.7% of patients requiring dialysis for more than 14 days, indicating prolonged DGF. Upon adjusting for confounding variables, HTK demonstrated a significantly lower risk of DGF than EC (OR 0.7350.82500.926), as did IGL-1 (OR 0.6050.7120.837). Similar protective effects were observed for prolonged DGF when comparing HTK (OR 0.4780.5990.749) and IGL-1 (OR 0.4780.6810.749) against EC. No significant association was found between preservation solutions and 1-year death-censored graft survival. In conclusion, EC was the most frequently used cold storage perfusion solution, demonstrating a higher incidence and duration of DGF compared with HTK and IGL-1, but with no impact on 1-year graft survival.