Sevinc Mustafa, Stamp Susan, Ling Jonathan, Carter Noel, Talbot David, Sheerin Neil S
Nephrology Departmant, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Transplant Proc. 2019 Jul-Aug;51(6):1785-1790. doi: 10.1016/j.transproceed.2019.03.025.
Hypothermic machine perfusion is used to improve renal perfusion and reduce the rate of early and late graft dysfunction. It has been used in our unit since 2001. It has 2 modes of flow: continuous or pulsatile. The aim of this study is to compare the modes of perfusion in terms of perfusion-related parameters, graft survival, and estimated glomerular filtration rate.
All donation after cardiac death kidneys between 2002 and 2014 were reviewed. A total of 64 pairs of kidneys were identified of which one kidney underwent pulsatile and the other continuous perfusion. Machine parameters including resistance and perfusion flow index levels at 0, 1, 2, 3, and 4 hours were recorded and glutathione S-transferase was measured in perfusate. Estimated glomerular filtration rate from the first week of transplant until the fifth year and graft survival rates were determined.
Machine parameters were similar at all time points. Estimated glomerular filtration rates and graft survival were the same irrespective of perfusion mode.
Pulsatile perfusion may be regarded as more physiological. However, we could not identify difference in outcome following transplant of kidneys from the same donor that had been perfused under pulsatile or continuous conditions.
低温机器灌注用于改善肾脏灌注并降低早期和晚期移植肾功能障碍的发生率。自2001年起，我们科室开始使用该技术。它有两种血流模式：连续或搏动性。本研究的目的是比较这两种灌注模式在灌注相关参数、移植物存活及估计肾小球滤过率方面的差异。
回顾2002年至2014年间所有心脏死亡后捐献的肾脏。共识别出64对肾脏，其中一个肾脏接受搏动性灌注，另一个接受连续性灌注。记录0、1、2、3和4小时时的机器参数，包括阻力和灌注流量指数水平，并测定灌注液中的谷胱甘肽S转移酶。确定移植后第一周直至第五年的估计肾小球滤过率及移植物存活率。
所有时间点的机器参数相似。无论灌注模式如何，估计肾小球滤过率及移植物存活率相同。
搏动性灌注可能被认为更符合生理状态。然而，我们未能发现同一供体的肾脏在搏动性或连续性条件下灌注后移植结果的差异。
