Single centre experience of hypothermic machine perfusion of kidneys from extended criteria deceased heart-beating donors: a comparative study

Introduction Kidneys from extended criteria donors are associated with higher rates of delayed graft function (DGF). Hypothermic machine perfusion (MP) for storage is associated with more favourable outcomes. Methods A retrospective analysis was performed in 93 patients where the kidney was stored using hypothermic MP (LifePort (R)) and compared to an age-matched control group where the kidney was stored in cold static storage (CSS) using University of Wisconsin solution. Results Median age was similar in both groups (59.2 years in MP vs 59.9 years in CSS, p = 0.5598). Mean cold storage time was 15.6 h in MP vs 17.9 h in CSS. Post transplant mean serum creatinine was as follows; MP group-144.7 mu mol/L at 1 month; 138.3 mu mol/L at 3 months and 129.5 mu mol/L at 12 months. In the CSS group-163 mu mol/L at 1 month; 154.9 mu mol/L at 3 months and 140.2 mu mol/L at 12 months. There was a statistically significant difference at 1 month (p = 0.0096) and 3 months (p = 0.0236). DGF was defined as the need for haemodialysis within 7 days post transplant. In the MP group, DGF occurred in 17.2 % patients with mean of 6 days (range 1-18). In the CSS group, 25.8 % patients with mean of 8.1 days (range 3-25). One-year graft survival rate was better in the MP group (97.85 vs 96.77 %). Conclusion Our experience to date recommends the use of hypothermic MP for storage of kidneys from extended criteria deceased heart-beating donors.