Ex vivo kidney machine perfusion: meta-analysis of randomized clinical trials.
An updated meta-analysis of 19 randomized trials confirms hypothermic machine perfusion meaningfully lowers delayed graft function risk in deceased-donor kidney transplants, while normothermic and brief oxygenated hypothermic approaches remain unproven.
Background
Machine perfusion is used as an alternative organ preservation strategy to static cold storage (SCS) with the aim of reducing delayed graft function (DGF) in deceased-donor kidney transplantation.
Study design
This systematic review and meta-analysis included 19 randomized controlled trials published between November 2018 and July 2023 comparing machine perfusion strategies with SCS, with DGF as the primary outcome.
Key findings
Hypothermic machine perfusion (HMP) reduced DGF risk overall (RR 0.77) and after both circulatory-death (RR 0.78) and brain-death (RR 0.73) donation. Full HMP reduced DGF risk (RR 0.69) while partial HMP did not (RR 0.92). Normothermic machine perfusion and short-term oxygenated hypothermic perfusion after SCS were equivalent to SCS alone for DGF and 1-year graft survival.
Category
Research
Source
The British Journal of Surgery
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