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HEMO life® 可改善肾移植受者的肾功能,与一项大型多中心前瞻性队列研究相比与冷缺血时间无关。

HEMO life® improves renal function independent of cold ischemia time in kidney recipients: A comparison with a large multicenter prospective cohort study.

机构信息

Department of Nephrology, CHU de Brest, Brest, France.

UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, Labex IGO, Brest, France.

出版信息

Artif Organs. 2022 Apr;46(4):597-605. doi: 10.1111/aor.14141. Epub 2021 Dec 24.

Abstract

BACKGROUND

M101 is an extracellular hemoglobin isolated from a marine lugworm and is present in the medical device HEMO life®. The clinical investigation OXYOP was a paired kidney analysis (n = 60) designed to evaluate the safety and performance of HEMO life® used as an additive to preservation solution in renal transplantation. The secondary efficacy endpoints showed less delayed graft function (DGF) and better renal function in the HEMO life® group but due to the study design cold ischemia time (CIT) was longer in the contralateral kidneys.

METHODS

An additional analysis was conducted including OXYOP patients and patients from the ASTRE database (n = 6584) to verify that the decrease in DGF rates observed in the HEMO life® group may not be due solely to the shorter CIT but also to HEMO life® performance. Kaplan-Meier estimate curves of cumulative probability of achieving a creatinine level below 250 µmol/L were generated and compared in both groups. A Cox model was used to test the effect of the explanatory variables (use of HEMO life® and CIT). Finally, a bootstrap strategy was used to randomly select smaller samples of patients and test them for statistical comparison in the ASTRE database.

RESULTS

Kaplan-Meier estimate curves confirmed the existence of a relation between DGF and CIT and Cox analysis showed a benefit in the HEMO life® group regardless of the associated CIT. Boostrap analysis confirmed these results.

CONCLUSIONS

The present study suggested that the better recovery of renal function observed among kidneys preserved with HEMO life® in the OXYOP study is a therapeutic benefit of this breakthrough innovative medical device.

摘要

背景

M101 是一种从海洋环节动物分离得到的细胞外血红蛋白,存在于医疗设备 HEMO life®中。临床研究 OXYOP 是一项配对肾脏分析(n=60),旨在评估 HEMO life®作为肾移植保存液添加剂的安全性和性能。次要疗效终点显示,HEMO life®组的延迟肾功能恢复(DGF)较少,肾功能更好,但由于研究设计,对侧肾脏的冷缺血时间(CIT)更长。

方法

进行了一项额外的分析,包括 OXYOP 患者和 ASTRE 数据库中的患者(n=6584),以验证在 HEMO life®组中观察到的 DGF 发生率降低不仅可能是由于 CIT 缩短,而且可能是由于 HEMO life®的性能。生成并比较了两组累积达到肌酐水平低于 250µmol/L的概率的 Kaplan-Meier 估计曲线。使用 Cox 模型测试解释变量(使用 HEMO life®和 CIT)的效果。最后,使用 bootstrap 策略随机选择较小的患者样本,并在 ASTRE 数据库中对其进行统计比较。

结果

Kaplan-Meier 估计曲线证实了 DGF 与 CIT 之间存在关系,Cox 分析显示无论相关 CIT 如何,HEMO life®组都有获益。bootstrap 分析证实了这些结果。

结论

本研究表明,在 OXYOP 研究中,用 HEMO life®保存的肾脏中观察到的肾功能更好恢复是这种突破性创新医疗设备的治疗益处。

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