• Am. J. Transplant. · Nov 2021

    Multicenter Study

    Improved short-term outcomes of kidney transplants in controlled donation after the circulatory determination of death with the use of normothermic regional perfusion.

    • María Padilla, Elisabeth Coll, Cristina Fernández-Pérez, Teresa Pont, Ángel Ruiz, Marina Pérez-Redondo, Eva Oliver, Lander Atutxa, José M Manciño, Domingo Daga, Eduardo Miñambres, José Moya, Bárbara Vidal, José M Dueñas-Jurado, Fernando Mosteiro, Alberto Rodríguez-Salgado, Esperanza Fernández-García, Ramón Lara, Domingo Hernández-Marrero, Belén Estébanez, María Luisa Rodríguez-Ferrero, María Barber, Fernando García-López, Amado Andrés, Carlos Santiago, Ana Zapatero, Rafael Badenes, Francisco Carrizosa, José J Blanco, José L Bernal, Francisco J Elola, Cristina Vidal, Christel Terrón, Pablo Castro, Jordi Comas, and Beatriz Domínguez-Gil.
    • Organización Nacional de Trasplantes, Madrid, Spain.
    • Am. J. Transplant. 2021 Nov 1; 21 (11): 3618-3628.

    AbstractNormothermic regional perfusion (NRP) allows the in situ perfusion of organs with oxygenated blood in donation after the circulatory determination of death (DCDD). We aimed at evaluating the impact of NRP on the short-term outcomes of kidney transplants in controlled DCDD (cDCDD). This is a multicenter, nationwide, retrospective study comparing cDCDD kidneys obtained with NRP versus the standard rapid recovery (RR) technique. During 2012-2018, 2302 cDCDD adult kidney transplants were performed in Spain using NRP (n = 865) or RR (n = 1437). The study groups differed in donor and recipient age, warm, and cold ischemic time and use of ex situ machine perfusion. Transplants in the NRP group were more frequently performed in high-volume centers (≥90 transplants/year). Through matching by propensity score, two cohorts with a total of 770 patients were obtained. After the matching, no statistically significant differences were observed between the groups in terms of primary nonfunction (p = .261) and mortality at 1 year (p =  .111). However, the RR of kidneys was associated with a significantly increased odds of delayed graft function (OR 1.97 [95% CI 1.43-2.72]; p < .001) and 1-year graft loss (OR 1.77 [95% CI 1.01-3.17]; p = .034). In conclusion, compared with RR, NRP appears to improve the short-term outcomes of cDCDD kidney transplants.© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.

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