Decrease of renal resistance during hypothermic oxygenated machine perfusion is associated with early allograft function in extended criteria donation kidney transplantation

Scientific Reports, vol. 10, pp. 17726

Abstract

Hypothermic oxygenated machine perfusion (HOPE) was recently tested in preclinical trials in kidney transplantation (KT). Here we investigate the effects of HOPE on extended-criteria-donation (ECD) kidney allografts (KA). Fifteen ECD-KA were submitted to 152 ± 92 min of end-ischemic HOPE and were compared to a matched group undergoing conventional-cold-storage (CCS) KT (n = 30). Primary (delayed graft function-DGF) and secondary (e.g. postoperative complications, perfusion parameters) endpoints were analyzed within 6-months follow-up. There was no difference in the development of DGF between the HOPE and CCS groups (53% vs. 33%, respectively; p = 0.197). Serum urea was lower following HOPE compared to CCS (p = 0.003), whereas the CCS group displayed lower serum creatinine and higher eGFR rates on postoperative days (POD) 7 and 14. The relative decrease of renal vascular resistance (RR) following HOPE showed a significant inverse association with serum creatinine on POD1 (r = - 0.682; p = 0.006) as well as with serum urea and eGFR. Besides, the relative RR decrease was more prominent in KA with primary function when compared to KA with DGF (p = 0.013). Here we provide clinical evidence on HOPE in ECD-KT after brain death donation. Relative RR may be a useful predictive marker for KA function. Further validation in randomized controlled trials is warranted.Trial registration: clinicaltrials.gov (NCT03378817, Date of first registration: 20/12/2017).

Authors 14

1. F. Meister Aachen Department of Surgery and Transplantation

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany

2. Zoltán Czigány Aachen Department of Surgery and Transplantation

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany

3. Hannah Miller Aachen Department of Surgery and Transplantation

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany

4. Sophie Reichelt Aachen Department of Surgery and Transplantation

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany

5. Wenjia Liu Aachen Department of Surgery and Transplantation

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany

6. Joerg Boecker Aachen Department of Surgery and Transplantation

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany

7. Marcus Johannes Moeller Aachen Division of Nephrology Department of Medicine II

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Division of Nephrology, Department of Medicine II, University Hospital RWTH Aachen, Aachen, Germany

8. Rene Hany Tolba Aachen Institute for Laboratory Animal Science and Experimental Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute for Laboratory Animal Science and Experimental Surgery, University Hospital RWTH Aachen, Aachen, Germany

9. Karim Hamesch Aachen Division of Gastroenterology and Hepatology Department of Medicine III

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Division of Gastroenterology and Hepatology, Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany

10. Pavel Strnad Aachen Division of Gastroenterology and Hepatology Department of Medicine III

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Division of Gastroenterology and Hepatology, Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany

11. Peter Boor Aachen Institute of Pathology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany

12. Christian Stoppe Aachen Department of Intensive Care Medicine

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Department of Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany

13. Ulf P. Neumann Aachen Department of Surgery and Transplantation

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany

14. Georg Lurje corresponding Aachen Department of Surgery and Transplantation

    Universitätsklinikum Aachen · Charité - Universitätsmedizin Berlin · RWTH Aachen University

    Affiliation as printed

    Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany. georg.lurje@charite.de

    Department of Surgery, Chirugische Klinik, Campus Charité Mitte|Campus Virchow Klinikum-Charité Universitätsmedizin Berlin, Berlin, Germany. georg.lurje@charite.de

    Department of Surgery, Chirugische Klinik, Campus Charité Mitte|Campus Virchow Klinikum–Charité Universitätsmedizin Berlin, Berlin, Germany