Offerni Juliano C M, Ai Li Erica, Matti Danny, Luke Grant, Luke Patrick P, Sener Alp
Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Matthew Mailing Center for Translational Transplant Studies, London, ON, Canada.
Transplant Direct. 2024 Mar 7;10(4):e1601. doi: 10.1097/TXD.0000000000001601. eCollection 2024 Apr.
Hypothermic machine perfusion (HMP) reduces renal injury in donation after circulatory death donors with a high Kidney Donor Profile Index (KDPI). This study aims to characterize the correlation between KDPI, HMP parameters, and donor vitals during the withdrawal period in predicting short- and long-term graft outcomes.
ANOVA with Tukey's honestly significant difference tests compared the relationship between average flow, average resistance, peak resistance, flow slope, and resistance slope on day 30, 1-y, and 3-y eGFR, and days of delayed graft function. Graft and recipient survival rates were assessed using Kaplan-Meier analysis.
The data for 72 grafts were suitable for analysis. Kidneys with KDPI >50% had a significantly higher day 30, and 1-y posttransplant eGFR, if HMP average flow was >150 mL/min, or the average resistance was <0.15 mm Hg/mL/min, compared with kidneys with also KDPI >50% but had not achieved the same pump parameters. There were no significant differences in the Kaplan-Meier analysis, considering recipient or graft survival, regardless of the KPDI score with 3- or 5-y outcomes.
Use of average resistance and average flow from a HMP, in conjunction with KDPI, may be predictive of the short- and long-term function of donation after circulatory death kidney transplants.
低温机器灌注（HMP）可减少肾脏捐赠者概况指数（KDPI）较高的循环死亡后捐赠者的肾损伤。本研究旨在描述KDPI、HMP参数与撤离期供体生命体征之间的相关性，以预测短期和长期移植结局。
采用带有Tukey真实显著性差异检验的方差分析，比较第30天、1年和3年估算肾小球滤过率（eGFR）以及移植肾功能延迟恢复天数时平均流量、平均阻力、峰值阻力、流量斜率和阻力斜率之间的关系。使用Kaplan-Meier分析评估移植物和受者生存率。
72个移植物的数据适合分析。与KDPI>50%但未达到相同泵参数的肾脏相比，如果HMP平均流量>150 mL/min或平均阻力<0.15 mmHg/mL/min，KDPI>50%的肾脏移植后第30天和1年的eGFR显著更高。在Kaplan-Meier分析中，无论KPDI评分如何，3年或5年结局的受者或移植物生存率均无显著差异。
结合KDPI使用HMP的平均阻力和平均流量，可能有助于预测循环死亡后肾移植的短期和长期功能。
