Volume 11 Issue 2
Mar.  2020
Turn off MathJax
Article Contents
Li Yang, Tian Xiaohui, Ding Chenguang, et al. Application of hypothermic machine perfusion in the renal transplantation from deceased donor with high-risk delayed graft function[J]. ORGAN TRANSPLANTATION, 2020, 11(2): 259-264. doi: 10.3969/j.issn.1674-7445.2020.02.012
Citation: Li Yang, Tian Xiaohui, Ding Chenguang, et al. Application of hypothermic machine perfusion in the renal transplantation from deceased donor with high-risk delayed graft function[J]. ORGAN TRANSPLANTATION, 2020, 11(2): 259-264. doi: 10.3969/j.issn.1674-7445.2020.02.012

Application of hypothermic machine perfusion in the renal transplantation from deceased donor with high-risk delayed graft function

doi: 10.3969/j.issn.1674-7445.2020.02.012
More Information
  • Corresponding author: Xue Wujun, Email: xwujun126@mail.xjtu.edu.cn
  • Received Date: 2019-12-29
    Available Online: 2021-01-19
  • Publish Date: 2020-03-15
  •   Objective  To evaluate the clinical effect of hypothermic machine perfusion (HMP) in the storage of renal grafts from deceased donor (DD) with high-risk delayed graft function (DGF).  Methods  Clinical data of 52 donors with high-risk DGF were collected in this prospective randomized controlled study. Two renal grafts from each donor were randomly divided into the HMP group (n=52) and static cold storage (SCS) group (n=52). In the HMP group, the renal grafts were stored by LifePort under HMP, whereas the renal grafts in the SCS group were preserved in University of Wisconsin solution (UW solution). The incidence of DGF and primary nonfunction (PNF) after renal transplantation was statistically compared between two groups. The recovery of renal graft function, the survival rates of the recipients and renal grafts within postoperative 1 year were observed in two groups.  Results  The incidence of DGF in the HMP group was 4%(2/52), significantly lower than 17% (9/52) in the SCS group (P < 0.05). No PNF was reported in the HMP group and 1 case of PND was noted in the SCS group, the difference was not statistically significant (P > 0.05). The recovery time of graft function of the recipients in the HMP and SCS groups were (7.2±0.6) d and (7.7±1.0) d with no statistical significance (P > 0.05). In the HMP group, the urine volume of the recipients on the day of operation, postoperative 1 and2 d was significantly larger than that in the SCS group (all P < 0.05). In the HMP group, the levels of serum creatinine at each time point after operation were significantly lower than those in the SCS group (all P < 0.05). The 1-year survival rates of the recipient and kidney were 98.1%, 92.3% and 100%, 96.2% in the HMP and SCS groups with no statistical significance (all P > 0.05).  Conclusions  HMP can significantly reduce the incidence of DGF after renal transplantation from DD with high-risk DGF and promote the early recovery of graft function.

     

  • loading
  • [1]
    Transplant Experts of the National Organ Donation and Transplantation Committee, Officers of National Health and Family Planning Commission, HUANG JF, et al. The new era of organ transplantation in China[J]. Chin Med J (Engl), 2016, 129(16):1891-1893. DOI: 10.4103/0366-6999.187865.
    [2]
    ROBERTSON MP, HINDE RL, LAVEE J. Analysis of official deceased organ donation data casts doubt on the credibility of China's organ transplant reform[J]. BMC Med Ethics, 2019, 20(1):79. DOI: 10.1186/s12910-019-0406-6.
    [3]
    PETERS-SENGERS H, HOUTZAGER JHE, IDU MM, et al. Impact of cold ischemia time on outcomes of deceased donor kidney transplantation: an analysis of a national registry[J]. Transplant Direct, 2019, 5(5):e448. DOI: 10.1097/TXD.0000000000000888.
    [4]
    阙宏亮, 韩志坚, 耿亮, 等.器官捐献肾移植受者近期预后的影响因素分析[J].南京医科大学学报(自然科学版), 2018, 38(5):616-621, 627.DOI: 10.7655/NYDXBNS20180509.

    QUE HL, HAN ZJ, GENG L, et al. Risk factors on the short-term outcome of DCD kidney transplanted recipients:a single center study[J]. J Nanjing Med Univ, 2018, 38(5):616-621, 627. DOI: 10.7655/NYDXBNS20180509.
    [5]
    GUO QH, LIU QL, HU XJ, et al. Comparison of nighttime and daytime operation on outcomes of kidney transplant with deceased donors: a retrospective analysis[J]. Chin Med J (Engl), 2019, 132(4):395-404. DOI: 10.1097/CM9.0000000000000056.
    [6]
    VAN HEURN LW, TALBOT D, NICHOLSON ML, et al. Recommendations for donation after circulatory death kidney transplantation in Europe[J]. Transpl Int, 2016, 29(7):780-789. DOI: 10.1111/tri.12682.
    [7]
    TEDESCO-SILVA H JUNIOR, MELLO OFFERNI JC, AYRES CARNEIRO V, et al. Randomized trial of machine perfusion versus cold storage in recipients of deceased donor kidney transplants with high incidence of delayed graft function[J]. Transplant Direct, 2017, 3(5):e155. DOI: 10.1097/TXD.0000000000000672.
    [8]
    谭晓宇, 陈晓兰, 林金铭, 等.机械灌注技术引领器官捐献与移植模式的变革——器官ICU时代即将到来?[J].器官移植, 2019, 10(4):453-458.DOI: 10.3969/j.issn.1674-7445.2019.04.018.

    TAN XY, CHEN XL, LIN JM, et al. Machine perfusion technology leads the transformation of organ donation and transplantation model: the age of organ ICU?[J]. Organ Transplant, 2019, 10(4):453-458.DOI: 10.3969/j.issn.1674-7445.2019.04.018.
    [9]
    DENG R, GU G, WANG D, et al. Machine perfusion versus cold storage of kidneys derived from donation after cardiac death: a Meta-analysis[J]. PLoS One, 2013, 8(3):e56368. DOI: 10.1371/journal.pone.0056368.
    [10]
    项和立, 薛武军, 田普训, 等.公民逝世后器官捐献供者的评估与维护[J].中华器官移植杂志, 2014, 35(7):392-395. DOI: 10.3760/cma.j.issn.0254-1785.2014.07.003.

    XIANG HL, XUE WJ, TIAN PX, et al. Donor evaluation and maintenance of donation after citizen's death[J]. Chin J Organ Transplant, 2014, 35(7):392-395. DOI: 10.3760/cma.j.issn.0254-1785.2014.07.003.
    [11]
    廖吉祥, 孙煦勇, 董建辉, 等.低温机械灌注在标准供者与扩大标准供者供肾保存中的临床效果研究[J].中华器官移植杂志, 2016, 37(8):462-467.DOI: 10.3760/cma.j.issn.0254-1785.2016.08.004.

    LIAO JX, SUN XY, DONG JH, et al. A clinical study on hypothermic machine perfusion in renal transplantation from standard criteria donors and extended criteria donors[J]. Chin J Organ Transplant, 2016, 37(8):462-467. DOI: 10.3760/cma.j.issn.0254-1785.2016.08.004.
    [12]
    YAO L, ZHOU H, WANG Y, et al. Hypothermic machine perfusion in DCD kidney transplantation: a single center experience[J]. Urol Int, 2016, 96(2):148-151. DOI: 10.1159/000431025.
    [13]
    DING CG, LI Y, TIAN XH, et al. Predictive score model for delayed graft function based on hypothermic machine perfusion variables in kidney transplantation[J]. Chin Med J (Engl), 2018, 131(22):2651-2657. DOI: 10.4103/0366-6999.245278.
    [14]
    薛武军, 项和立, 丁晨光, 等.公民逝世后器官捐献供者评估标准的研究[J].现代泌尿外科杂志, 2016, 21(2):99-103.DOI: 10.3969/j.issn.1009-8291.2016.02.007.

    XUE WJ, XIANG HL, DING CG, et al. Study on the assessment standard of organ quality in China donation after citizen's death[J]. J Mod Urol, 2016, 21(2):99-103. DOI: 10.3969/j.issn.1009-8291.2016.02.007.
    [15]
    柳乾龙, 薛武军, 李杨, 等.低温机械灌注与单纯冷保存在肾移植供肾保存中效果的比较[J].中华器官移植杂志, 2018, 39(5):276-281.DOI:10.3760/cma.j.issn.0254- 1785.2018.05.004.

    LIU QL, XUE WJ, LI Y, et al. The comparison between hypothermic machine perfusion and simple cold storage in Chinese donation after citizen's deathkidney transplantation[J]. Chin J Organ Transplant, 2018, 39(5):276-281. DOI:10.3760/cma.j.issn.0254-1785. 2018.05.004.
    [16]
    MALLON DH, SUMMERS DM, BRADLEY JA, et al. Defining delayed graft function after renal transplantation: simplest is best[J]. Transplantation, 2013, 96(10):885-889. DOI: 10.1097/TP.0b013e3182a19348.
    [17]
    HU XJ, ZHENG J, LI Y, et al. Prediction of kidney transplant outcome based on different DGF definitions in Chinese deceased donation[J]. BMC Nephrol, 2019, 20(1):409. DOI: 10.1186/s12882-019-1557-x.
    [18]
    RODRÍGUEZ CASTELLANOS FE, DOMÍNGUEZ QUINTANA F, SOTO ABRAHAM V, et al. Classification of acute rejection episodes in kidney transplantation: a proposal based on factor analysis[J]. Iran J Kidney Dis, 2018, 12(2):123-131. http://cn.bing.com/academic/profile?id=963cc57178d39a9f35c303b809e08f68&encoded=0&v=paper_preview&mkt=zh-cn
    [19]
    DOMÍNGUEZ JI, DE AMESTI M, MAJERSON A. Hypothermic machine perfusion versus static cold preservation in kidney transplantation[J]. Medwave, 2018, 18(7):e7360. DOI: 10.5867/medwave.2018.07.7359.
    [20]
    KOX J, MOERS C, MONBALIU D, et al. The benefits of hypothermic machine preservation and short cold ischemia times in deceased donor kidneys[J]. Transplantation, 2018, 102(8):1344-1350. DOI: 10.1097/TP.0000000000002188.
    [21]
    SANDAL S, LUO X, MASSIE AB, et al. Machine perfusion and long-term kidney transplant recipient outcomes across allograft risk strata[J]. Nephrol Dial Transplant, 2018, 33(7):1251-1259. DOI: 10.1093/ndt/gfy010.
    [22]
    WANG W, XIE D, HU X, et al. Effect of hypothermic machine perfusion on the preservation of kidneys donated after cardiac death: a single-center, randomized, controlled trial[J]. Artif Organs, 2017, 41(8):753-758. DOI: 10.1111/aor.12836.
    [23]
    TAI Q, XUE W, DING X, et al. Perfusion parameters of donation after cardiac death kidneys predict early transplant outcomes based on expanded criteria donor designation[J]. Transplant Proc, 2018, 50(1):79-84. DOI: 10.1016/j.transproceed.2017.11.018.
    [24]
    TINGLE SJ, FIGUEIREDO RS, MOIR JA, et al. Hypothermic machine perfusion is superior to static cold storage in deceased donor kidney transplantation; a Meta-analysis[J]. Clin Transplant, 2020:e13814. DOI: 10.1111/ctr.13814.
    [25]
    TUGMEN C, SERT I, KEBABCI E, et al. Delayed graft function in kidney transplantation: risk factors and impact on early graft function[J]. Prog Transplant, 2016, 26(2):172-177. DOI: 10.1177/1526924816640978.
    [26]
    O'NEILL S, ONISCU GC. Donor pretreatment and machine perfusion: current views[J]. Curr Opin Organ Transplant, 2020, 25(1):59-65. DOI: 10.1097/MOT.0000000000000725.
    [27]
    中华医学会器官移植学分会.尸体供肾体外机械灌注冷保存技术操作规范(2019版)[J].器官移植, 2019, 10(3): 263-266. DOI: 10.3969/j.issn.1674-7445.2019.03. 007.

    Branch of Organ Transplantation of Chinese Medical Association. Technical operation specifcation for the extracorporeal mechanical perfusion and cold preservation of the deceased donor kidney (2019 edition)[J]. Organ Transplant, 2019, 10(3): 263-266. DOI: 10.3969/j.issn. 1674-7445.2019.03.007.
    [28]
    中华医学会器官移植学分会.供肾灌注、保存及修复技术操作规范(2019版)[J].器官移植, 2019, 10(5): 473-477. DOI: 10.3969/j.issn.1674-7445.2019.05.002.

    Branch of Organ Transplantation of Chinese Medical Association. Technical operation specification for perfusion, preservation and repair of donor kidney (2019 edition)[J]. Organ Transplant, 2019, 10(5): 473-477. DOI: 10.3969/j.issn.1674-7445.2019.05.002.
    [29]
    中华医学会器官移植学分会.肾移植术后移植物功能延迟恢复诊疗技术规范(2019版)[J].器官移植, 2019, 10(5): 521-525. DOI: 10.3969/j.issn.1674-7445.2019.05.010.

    Branch of Organ Transplantation of Chinese Medical Association. Technical specification for the diagnosis and treatment on delayed graft function after renal transplantation (2019 edition)[J]. Organ Transplant, 2019, 10(5): 521-525. DOI: 10.3969/j.issn.1674-7445.2019.05.010.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)

    Article Metrics

    Article views (145) PDF downloads(28) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return