Cold machine perfusion versus static cold storage of kidneys donated after cardiac death: a UK multicenter randomized controlled trial

Am J Transplant. 2010 Sep;10(9):1991-9. doi: 10.1111/j.1600-6143.2010.03165.x.

Watson CJ, Wells AC, Roberts RJ, Akoh JA, Friend PJ, Akyol M, Calder FR, Allen JE, Jones MN, Collett D, Bradley JA.

Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge. cjew2@cam.ac.uk

Abstract

"One third of deceased donor kidneys for transplantation in the UK are donated following cardiac death (DCD). Such kidneys have a high rate of delayed graft function (DGF) following transplantation. We conducted a multicenter, randomized controlled trial to determine whether kidney preservation using cold, pulsatile machine perfusion (MP) was superior to simple cold storage (CS) for DCD kidneys. One kidney from each DCD donor was randomly allocated to CS, the other to MP. A sequential trial design was used with the primary endpoint being DGF, defined as the necessity for dialysis within the first 7 days following transplant. The trial was stopped when data were available for 45 pairs of kidneys. There was no difference in the incidence of DGF between kidneys assigned to MP or CS (58 per cent vs. 56 per cent, respectively), in the context of an asystolic period of 15 min and median cold ischemic times of 13.9 h for MP and 14.3 h for CS kidneys. Renal function at 3 and 12 months was similar between groups, as was graft and patient survival. For kidneys from controlled DCD donors (with mean cold ischemic times around 14 h), MP offers no advantage over CS, which is cheaper and more straightforward."

Copyright 2010 The Authors Journal compilation © 2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

Source:

http://www.ncbi.nlm.nih.gov/pubmed/20883534

* Période d’ischémie chaude

Ce terme désigne le délai entre l’arrêt cardiaque et l’instauration des mesures de conservation des organes. Le début de la période d’ischémie chaude varie dans la pratique; par exemple, ce délai commence à partir de l’asystole, de l’interruption du maintien des fonctions vitales ou de l’atteinte de seuils vitaux définis à l’avance. Le début de la perfusion froide est généralement considéré comme la fin de la période d’ischémie chaude. La définition de la période d’ischémie chaude a des répercussions importantes sur la viabilité des organes aux fins de transplantation.

Période d’ischémie froide

Intervalle entre le début de la conservation d’un organe prélevé et sa transplantation (greffe).

Source :

http://www.organsandtissues.ca/francais/glossaire/o-s.htm