Normothermic machine perfusion versus static cold storage in donation after circulatory death kidney transplantation: a randomized controlled trial
A large UK randomized trial found that adding one hour of normothermic machine perfusion to standard cold storage did not reduce delayed graft function in kidneys from circulatory-death donors, though the technique was confirmed safe and feasible.
Background
Kidneys from donation-after-circulatory-death (DCD) donors are more vulnerable to cold ischemic injury and delayed graft function (DGF) than those from donors after brain death. Normothermic machine perfusion (NMP) has been proposed to mitigate this injury by restoring near-physiological conditions before transplantation.
Study design
In this multicenter randomized controlled trial, 338 DCD kidneys were allocated to static cold storage (SCS) alone or SCS plus one hour of NMP, with 277 kidneys included in the intention-to-treat analysis. The primary endpoint was DGF, defined as need for dialysis in the first 7 days post-transplant.
Key findings
DGF occurred in 60.7% of NMP kidneys versus 58.5% of SCS-only kidneys, a non-significant difference (adjusted OR 1.13, 95% CI 0.69-1.84; P=0.624).
Safety
NMP was not associated with any increase in transplant thrombosis, infectious complications, or other adverse events, confirming it is feasible and safe for clinical use even though it did not improve the primary outcome.
Category
Transplant
Source
Nature Medicine
More from ASNRT News
Browse the latest news, society announcements, KDIGO guideline updates, and AJNT issue releases on the ASNRT newsroom.