A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation
Hypothermic machine perfusion (HMP) has been introduced as an alternative to static cold storage (SCS) in kidney transplantation, but its true benefit in the clinical routine remains incompletely understood. The aim of this study was to assess the effect of HMP vs. SCS in kidney transplantation. All kidney transplants performed between 08/2015 and 12/2019 (n = 347) were propensity score (PS) matched for cold ischemia time (CIT), extended criteria donor (ECD), gender mismatch, cytomegalovirus (CMV) mismatch, re-transplantation and Eurotransplant (ET) senior program. A total of 103 HMP and 103 SCS instances fitted the matching criteria. Prior to PS matching, the CIT was longer in the HMP group (17.5 h vs. 13.3 h; p < 0.001), while the delayed graft function (DGF) rates were 29.8% and 32.3% in HMP and SCS, respectively. In the PS matched groups, the DGF rate was 64.1% in SCS vs. 31.1% following HMP: equivalent to a 51.5% reduction of the DGF rate (OR 0.485, 95% CI 0.318-0.740). DGF was associated with decreased 1- and 3-year graft survival (100% and 96.3% vs. 90.8% and 86.7%, p = 0.001 and p = 0.008) or a 4.1-fold increased risk of graft failure (HR = 4.108; 95% CI: 1.336-12.631; p = 0.014). HMP significantly reduces DGF in kidney transplantation. DGF remains a strong predictor of graft survival.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
|---|---|
| Enthalten in: |
Journal of clinical medicine - 9(2020), 7 vom: 21. Juli |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Gasteiger, Silvia [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Delayed graft function |
|---|
| Anmerkungen: |
Date Revised 28.09.2020 published: Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.3390/jcm9072311 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM31284154X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM31284154X | ||
| 003 | DE-627 | ||
| 005 | 20231225145259.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3390/jcm9072311 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1042.xml |
| 035 | |a (DE-627)NLM31284154X | ||
| 035 | |a (NLM)32708180 | ||
| 035 | |a (PII)E2311 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Gasteiger, Silvia |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 28.09.2020 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Hypothermic machine perfusion (HMP) has been introduced as an alternative to static cold storage (SCS) in kidney transplantation, but its true benefit in the clinical routine remains incompletely understood. The aim of this study was to assess the effect of HMP vs. SCS in kidney transplantation. All kidney transplants performed between 08/2015 and 12/2019 (n = 347) were propensity score (PS) matched for cold ischemia time (CIT), extended criteria donor (ECD), gender mismatch, cytomegalovirus (CMV) mismatch, re-transplantation and Eurotransplant (ET) senior program. A total of 103 HMP and 103 SCS instances fitted the matching criteria. Prior to PS matching, the CIT was longer in the HMP group (17.5 h vs. 13.3 h; p < 0.001), while the delayed graft function (DGF) rates were 29.8% and 32.3% in HMP and SCS, respectively. In the PS matched groups, the DGF rate was 64.1% in SCS vs. 31.1% following HMP: equivalent to a 51.5% reduction of the DGF rate (OR 0.485, 95% CI 0.318-0.740). DGF was associated with decreased 1- and 3-year graft survival (100% and 96.3% vs. 90.8% and 86.7%, p = 0.001 and p = 0.008) or a 4.1-fold increased risk of graft failure (HR = 4.108; 95% CI: 1.336-12.631; p = 0.014). HMP significantly reduces DGF in kidney transplantation. DGF remains a strong predictor of graft survival | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a delayed graft function | |
| 650 | 4 | |a hypothermic machine perfusion | |
| 650 | 4 | |a kidney transplantation | |
| 700 | 1 | |a Berchtold, Valeria |e verfasserin |4 aut | |
| 700 | 1 | |a Bösmüller, Claudia |e verfasserin |4 aut | |
| 700 | 1 | |a Dostal, Lucie |e verfasserin |4 aut | |
| 700 | 1 | |a Ulmer, Hanno |e verfasserin |4 aut | |
| 700 | 1 | |a Bogensperger, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Resch, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Rudnicki, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Neuwirt, Hannes |e verfasserin |4 aut | |
| 700 | 1 | |a Oberhuber, Rupert |e verfasserin |4 aut | |
| 700 | 1 | |a Cardini, Benno |e verfasserin |4 aut | |
| 700 | 1 | |a Scheidl, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Mayer, Gert |e verfasserin |4 aut | |
| 700 | 1 | |a Öfner, Dietmar |e verfasserin |4 aut | |
| 700 | 1 | |a Weissenbacher, Annemarie |e verfasserin |4 aut | |
| 700 | 1 | |a Schneeberger, Stefan |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of clinical medicine |d 2012 |g 9(2020), 7 vom: 21. Juli |w (DE-627)NLM230666310 |x 2077-0383 |7 nnns |
| 773 | 1 | 8 | |g volume:9 |g year:2020 |g number:7 |g day:21 |g month:07 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3390/jcm9072311 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 9 |j 2020 |e 7 |b 21 |c 07 | ||