Normothermic versus hypothermic machine perfusion in kidney transplantation: A randomized controlled trial.
A randomized trial in high-risk deceased-donor kidneys found that adding two hours of normothermic perfusion on top of standard hypothermic machine perfusion did not improve immediate graft function compared with hypothermic perfusion alone.
Background
Hypothermic machine perfusion (HMP) is the current gold-standard preservation method for deceased-donor kidneys, but extended-criteria and donation-after-circulatory-death grafts remain at high risk of delayed graft function. Adding a period of normothermic machine perfusion (NMP) has been proposed to restore physiological activity before implantation.
Study design
In this single-center, open-label, superiority RCT, 80 patients were randomized to receive a kidney preserved with HMP plus 2 hours of end-ischemic HMP+NMP, or HMP alone. The primary outcome was incidence of immediate graft function.
Key findings
Immediate graft function occurred in 39% of the HMP+NMP group versus 49% of the HMP-alone group, a non-significant difference (OR 0.68, 95% CI 0.28-1.64; P=0.38), with no significant differences in secondary outcomes either.
Category
Transplant
Source
American Journal of Transplantation
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