Clinical application of mechanical perfusion in donation after citizen’s death donor renal transplantation

Abstract

Objective To explore the clinical effect of LifePort® mechanical perfusion in donation after citizen's death (DCD) donor renal transplantation. Method From December 2011 to April 2015, 183 cases of DCD and 340 cases of DCD donor renal transplantation were implemented in our transplant center. 145 DCD donors' kidneys were preserved by LifePort® mechanical perfusion, 286 kidneys for transplantation; the 28 DCD donors' kidneys were preserved by static cold preservation, 54 kidneys for transplantation. Clinical data were analyzed retrospectively. Result 286 kidneys preserved by LifePort® mechanical perfusion were transplanted, with perfusion time (2.9±1.6) h, perfusion pressure (26.9±8.7) mmHg, resistance index (0.24±0.17) mmHg·ml-1·min-1, and perfusion flow (91.2±35.6) ml/min. Four kidneys were discarded, with resistance index (0.62±0.27) mmHg·ml-1·min-1, and perfusion flow (46.2±8.7) ml/min. In 340 cases of renal transplant recipients, 45 cases developed renal delayed graft function (DGF), with the incidence being 13.2%, meanwhile the incidence of DGF was 24.1% (13/54) in recipients of donor kidneys preserved by static cold preservation and 11.2% (32/286) in recipients of donor kidneys preserved by LifePort® mechanical perfusion (P<0.05) respectively. The recovery time of renal function in recipients of donor kidney preserved by LifePort® mechanical perfusion was significantly shorter than that in static cold preservation donor kidney recipients [(4.8±1.5) vs. (8.7±2.6) days, P<0.05]. Conclusion The LifePort® mechanical perfusion can evaluate donor kidney quality, promote the early recovery of transplant renal function and reduce the incidence of kidney transplant DGF. Key words: Kidney transplantation; Donors; Mechanical perfusion