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

机译：心脏死亡后捐献的肾脏的冷机灌注与静态冷库：一项英国多中心随机对照试验。

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摘要

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% vs. 56%, 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.
机译：在英国，三分之一的死者供肾移植是在心脏死亡（DCD）后捐赠的。此类肾脏在移植后具有较高的延迟移植功能（DGF）率。我们进行了一项多中心随机对照试验，以确定对于DCD肾脏而言，使用冷的脉动机器灌注（MP）进行肾脏保存是否优于单纯冷藏（CS）。每个DCD供体的一个肾脏随机分配给CS，另一个分配给MP。使用顺序试验设计，主要终点为DGF，定义为移植后前7天内进行透析的必要性。当有45对肾脏的数据可用时，该试验停止。在收缩期为15分钟，中位冷缺血时间为MP的14.3 h（13.9 h）的情况下，分配给MP或CS的肾脏之间DGF的发生率没有差异（分别为58％和56％）。用于CS肾脏。各组在3个月和12个月时的肾功能相似，移植物和患者的存活率也相似。对于来自受控DCD供体的肾脏（平均寒冷缺血时间约为14小时），MP较CS没有优势，后者更便宜，更直接。

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