Hypothermic machine perfusion improves Doppler ultrasonography resistive indices and long-term allograft function after renal transplantation: a single-centre analysis
Hypothermic machine perfusion improves Doppler ultrasonography resistive indices and long-term allograft function after renal transplantation: a single-centre analysis
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DOI：
10.1111/bju.12960
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发表时间：
2015-12-01
影响因子：
4.5
通讯作者：
Sener, Alp
中科院分区：
文献类型：
--
作者：
Dion, Marie S.;McGregor, Thomas B.;Sener, Alp
ObjectivesTo评估低温机灌注（HMP）移植肾是否可以改善长期移植肾功能相比，静态冷藏（CS）。MethodsWe评估是否移植物多普勒超声阻力指数改善与使用HMP相比，CS保存，并检查这些改善是否是长期移植肾功能的预测。共检查了30例肾移植（15对）。将其中一对肾置于CS上并首先移植（CS组，n = 15）。另一肾置于HMP上，CS组（HMP组，n = 15）后移植。在移植后第1天和第7天进行多普勒超声检查，并评估阻力指数。估计肾小球滤过率（eGFR）监测24个月后transplantation.ResultsDespite较长的冷缺血时间，肾脏维持HMP有较低的阻力指数（P = 0.005），相应较高的eGFR在整个后续。亚组分析表明，HMP诱导的改善，术后eGFR是最大的肾脏捐赠后心脏死亡（DCD），即使在2年后transplantation（P = 0.008）.ConclusionsHMP的移植肾出现，以改善移植后血管阻力，并有一个积极的影响，长期移植肾功能相比，CS在人群中的DCD肾的受体。
ObjectivesTo evaluate whether hypothermic machine perfusion (HMP) of transplanted kidneys can improve long-term renal allograft function compared with static cold storage (CS).MethodsWe evaluated whether graft Doppler ultrasonography resistive indices improved with the use of HMP compared with CS preservation, and examined whether these improvements were predictive of long-term graft function. A total of 30 kidney transplants (15 pairs) were examined. One of the kidney pairs was placed on CS and transplanted first (CS group, n = 15). The other kidney of each pair was placed on HMP and transplanted after the CS group (HMP group, n = 15). Doppler ultrasonography was performed on days 1 and 7 after transplantation and resistive indices were evaluated. The estimated glomerular filtration rate (eGFR) was monitored for 24 months after transplantation.ResultsDespite longer cold ischaemia times, kidneys maintained with HMP had lower resistive indices (P = 0.005) with correspondingly higher eGFR throughout the follow-up. Subgroup analysis showed that the HMP-induced improvement in postoperative eGFR was greatest in kidneys obtained from donation after cardiac death (DCD), even at 2 years after transplantation (P = 0.008).ConclusionsHMP of transplant kidneys appears to improve vascular resistance after transplantation and has a positive impact on long-term allograft function compared with CS in the population of recipients of DCD kidneys.