Normothermic Ex Vivo Kidney Perfusion for Human Kidney Transplantation: First North American Results
Normothermic Ex Vivo Kidney Perfusion for Human Kidney Transplantation: First North American Results
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DOI：
10.1097/tp.0000000000004098
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发表时间：
2022-09-01
期刊：
影响因子：
6.2
通讯作者：
Selzner, Markus
中科院分区：
文献类型：
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作者：
Mazilescu, Laura, I;Urbanellis, Peter;Selzner, Markus
背景在临床前研究中，常温离体肾灌注（NEVKP）在同种异体肾移植物的保存、评估和修复方面显示出有希望的结果。在这里，我们报告了第一个北美的安全性和可行性研究死亡供体肾移植后，保存与NEVKP。方法.将13例在缺氧低温机器灌注装置中运输后接受1至3小时NEVKP的人肾移植物的结果与仅用缺氧低温机器灌注保存的26例移植物的匹配对照组进行比较。结果移植物的灌注时间中位数为171 min（范围：44-275 min）。NEVKP组移植肾功能延迟恢复率为30.8%，对照组为46.2%（P = 0.51）。在1年的随访中，研究组和对照组的术后移植物功能（通过血清肌酐、透析必要性和尿量测量）无差异。两组间移植后1年移植物或患者存活率无差异。结论.我们的研究证明了NEVKP用于人类死亡供体肾移植的安全性和可行性。进一步的研究是必要的，以探讨如何这项技术可以尽量减少冷缺血，改善移植后移植肾功能，并评估和修复扩大标准的肾移植。
Background. Normothermic ex vivo kidney perfusion (NEVKP) has shown promising results for preservation, assessment, and reconditioning of kidney allografts in preclinical studies. Here, we report the first North American safety and feasibility study of deceased donor kidneys grafts transplanted following preservation with NEVKP. Methods. Outcomes of 13 human kidney grafts that received 1 to 3 h of NEVKP after being transported in an anoxic hypothermic machine perfusion device were compared with a matched control group of 26 grafts that were preserved with anoxic hypothermic machine perfusion alone. Results. Grafts were perfused for a median of 171 min (range, 44-275 min). The delayed graft function rate in NEVKP versus control patients was 30.8% versus 46.2% (P = 0.51). During the 1-y follow-up, no differences in postoperative graft function, measured by serum creatinine, necessity for dialysis, and urine production, were found between the study group and the control group. There were no differences in 1 y posttransplantation graft or patient survival between the 2 groups. Conclusions. Our study demonstrates the safety and feasibility of NEVKP for human deceased donor kidney transplantation. Further studies are warranted to explore how this technology can minimize cold ischemia, improve posttransplant graft function, and assess and repair expanded criteria kidney grafts.