Impact of Machine Perfusion Parameters on Renal Graft Outcomes

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Introduction: The aim of the study is to evaluate the machine perfusion parameters as decision making tool in discarding cadaveric kidneys. Methods: Data was collected for all the kidneys preserved with Machine Perfusion (MP) from May 2008 till January 2012. Kidneys were perfused with KPS1 using Life port machine. Machine perfusion parameters were downloaded from Organ Recovery System data station and clinical data was retrieved from prospectively maintained database. Results are expressed as means and percentages. P values were calculated by Chi-square test or Fisher's Exact test as appropriate (< 0.05 is considered statistically significant). Results: A total of 138 kidneys were machine perfused during the study period. Of these 14 were discarded; 2 for renal cell cancer, 3 for vascular injury and 9 for poor perfusion parameters (high resistance, low flow). 124 kidneys were implanted, 13 of them were implanted in seven pairs of dual kidneys whilst the rest were implanted as single grafts. 44 DBD and 80 DCD kidneys were machine perfused. The mean resistance at the termination of perfusion (TR) in both the groups was similar 0.27 vs. 0.26 respectively. Based on resistance the kidneys were divided into three groups Group I: TR < 0.4 (n=106), Group 2: TR = 0.4 to -0.6 (n=12), Group 3: TR > 0.6 (n=6). Primary function (PF) was 57, 58 and 50 % in the three groups respectively (p=1.000). DGF rate was 37.7% (p=0.765), 41.7% (p=0.677) and 50.0% (p=1.000) in group 1, 2 and 3 respectively. Only one PNF was observed in Group 1. One year graft survival (GS) was 92.5%, 91.7% and 83.3%. When graft outcomes were compared to the duration of machine perfusion (table1) and the MP proportion of CIT (table 2), no differences were detected.Table: No Caption available.Table: No Caption available.Conclusion: High resistance values, duration of MP and proportion of MP as function of total CIT do not impact on graft outcome. High resistance values on machine perfusion should not be used as stand-alone guide to discard kidneysion (table1) and the MP proportion of CIT (table 2), no differences were detected.