Transplantation Direct (Apr 2024)

Can We Predict Kidney Graft Function and Graft Survival Using Hypothermic Machine Perfusion Parameters From Donors After Circulatory Death?

  • Juliano C. M. Offerni, MD,
  • Erica Ai Li,
  • Danny Matti, MD,
  • Grant Luke, BSc,
  • Patrick P. Luke, MD,
  • Alp Sener, MD, PhD

DOI
https://doi.org/10.1097/TXD.0000000000001601
Journal volume & issue
Vol. 10, no. 4
p. e1601

Abstract

Read online

Background. Hypothermic machine perfusion (HMP) reduces renal injury in donation after circulatory death donors with a high Kidney Donor Profile Index (KDPI). This study aims to characterize the correlation between KDPI, HMP parameters, and donor vitals during the withdrawal period in predicting short- and long-term graft outcomes. Methods. ANOVA with Tukey’s honestly significant difference tests compared the relationship between average flow, average resistance, peak resistance, flow slope, and resistance slope on day 30, 1-y, and 3-y eGFR, and days of delayed graft function. Graft and recipient survival rates were assessed using Kaplan-Meier analysis. Results. The data for 72 grafts were suitable for analysis. Kidneys with KDPI >50% had a significantly higher day 30, and 1-y posttransplant eGFR, if HMP average flow was >150 mL/min, or the average resistance was 50% but had not achieved the same pump parameters. There were no significant differences in the Kaplan-Meier analysis, considering recipient or graft survival, regardless of the KPDI score with 3- or 5-y outcomes. Conclusions. Use of average resistance and average flow from a HMP, in conjunction with KDPI, may be predictive of the short- and long-term function of donation after circulatory death kidney transplants.