| Title: |
A Comprehensive Analysis on the Impact of Hypothermic Machine Perfusion and its Influence on Delayed Graft Function |
| Authors: |
Zhihao Li, MD; Mohammed Y. Mahgoub, MD; Ahmed Zeen Alabedeen Alrifai, MD; Byron Smith, PhD, MS; Randi J. Ryan, MD, MS; Girish K. Mour, MBBS; Caroline C. Jadlowiec, MD; Naim Issa, MD; Alexander R. Cortez, MD; Samy Riad, MD, MS, FAST |
| Source: |
Transplantation Direct, Vol 11, Iss 12, p e1875 (2025) |
| Publisher Information: |
Wolters Kluwer |
| Publication Year: |
2025 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
Surgery; RD1-811 |
| Description: |
Background. Delayed graft function (DGF) in deceased-donor kidney transplantation increases morbidity, prolongs hospitalization, and increases healthcare costs. Hypothermic machine perfusion (HMP) has emerged as a promising strategy to reduce DGF; however, large-scale real-world data remain limited. Methods. We performed a retrospective cohort analysis using the Scientific Registry of Transplant Recipients (2014–2024), including adult dialysis-dependent recipients of deceased-donor kidneys preserved using either static cold storage (SCS) or HMP. The primary outcome was DGF, defined as dialysis requirement within 7 d posttransplant. A matched-pairs analysis was conducted using kidneys from the same donor. Results. The overall cohort included 59 859 recipients (46.8% SCS, 53.2% HMP), with 2208 matched pairs identified. In the overall cohort, HMP grafts had longer cold ischemia times and a higher kidney donor risk index. They were more frequently obtained from older and donation after circulatory death donors. Although the overall DGF incidence was higher with HMP (34.4% versus 30.9%, P < 0.001), matched-pairs analysis revealed significantly lower DGF rates with HMP (29.8% versus 36.1%, P < 0.001). Adjusted analyses identified HMP as protective against DGF (overall cohort odds ratio, 0.71; 95% confidence interval, 0.66-0.78; paired cohort OR, 0.68; 95% CI, 0.50-0.93). Additional modifiable risk factors include prolonged cold ischemia time, higher recipient body mass index, and longer dialysis duration. Conclusions. This real-world study demonstrates that HMP is associated with a significant reduction in DGF risk in kidney transplantation compared with SCS, supporting its broader implementation and targeted management of modifiable risk factors. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001875; https://doaj.org/toc/2373-8731; https://doaj.org/article/a466ff5ae70c4b8c9e4bd221f7c2d1bc |
| DOI: |
10.1097/TXD.0000000000001875 |
| Availability: |
https://doi.org/10.1097/TXD.0000000000001875; https://doaj.org/article/a466ff5ae70c4b8c9e4bd221f7c2d1bc |
| Accession Number: |
edsbas.B04EEFF0 |
| Database: |
BASE |