TY - JOUR
T1 - The Effect of Perfusate Temperature on Delayed Graft Function in Deceased Donor Renal Transplantation
AU - Sweet, Ashley L.
AU - Connelly, Christopher R.
AU - Dewey, Elizabeth N.
AU - Scott, David L.
N1 - Publisher Copyright:
© 2023, NATCO. All rights reserved.
PY - 2023/12
Y1 - 2023/12
N2 - Introduction: Renal allograft hypothermic machine perfusion results in a decreased incidence of delayed graft function compared with static cold storage. Ensuring perfusate temperatures remain within the target range of 4-10 °C may impact delayed graft function rates. Project Aims: To identify whether this target was achieved and, if not, whether higher perfusate temperature was associated with delayed graft function. Design: In this retrospective cohort study, transplanted grafts from deceased donors placed on hypothermic machine perfusion pump from June 2019 to August 2020 were analyzed. Measurements were recovered after 5, 15, 60, and 180 min of perfusion. Univariable and multivariable analyses were performed to identify predictors of delayed graft function. Results: A total of 113 grafts from 94 donors were analyzed. Of these, 21 (19%) developed delayed graft function. On univariable logistic regression, variables associated with delayed graft function included older donor age (OR 1.08, P =.002), higher Kidney Donor Profile Index score (OR 1.03, P =.024), and higher 5-min perfusate temperature (T5 min; OR 1.49, P =.014). A higher T5 min was also associated with delayed graft function in multivariable logistic regression models (OR 1.58, P =.005; OR 1.37, P =.08). Grafts with T5 min >10 °C were more likely to experience delayed graft function than those with T5 min <10 °C (OR 4.5, P =.006). Conclusion: Higher early perfusate temperature was an independent predictor of delayed graft function and may be due to inadequate cooling of the circuit prior to placing grafts on pump. Quality improvement initiatives targeting early perfusate temperatures of ≤10 °C may reduce delayed graft function incidence.
AB - Introduction: Renal allograft hypothermic machine perfusion results in a decreased incidence of delayed graft function compared with static cold storage. Ensuring perfusate temperatures remain within the target range of 4-10 °C may impact delayed graft function rates. Project Aims: To identify whether this target was achieved and, if not, whether higher perfusate temperature was associated with delayed graft function. Design: In this retrospective cohort study, transplanted grafts from deceased donors placed on hypothermic machine perfusion pump from June 2019 to August 2020 were analyzed. Measurements were recovered after 5, 15, 60, and 180 min of perfusion. Univariable and multivariable analyses were performed to identify predictors of delayed graft function. Results: A total of 113 grafts from 94 donors were analyzed. Of these, 21 (19%) developed delayed graft function. On univariable logistic regression, variables associated with delayed graft function included older donor age (OR 1.08, P =.002), higher Kidney Donor Profile Index score (OR 1.03, P =.024), and higher 5-min perfusate temperature (T5 min; OR 1.49, P =.014). A higher T5 min was also associated with delayed graft function in multivariable logistic regression models (OR 1.58, P =.005; OR 1.37, P =.08). Grafts with T5 min >10 °C were more likely to experience delayed graft function than those with T5 min <10 °C (OR 4.5, P =.006). Conclusion: Higher early perfusate temperature was an independent predictor of delayed graft function and may be due to inadequate cooling of the circuit prior to placing grafts on pump. Quality improvement initiatives targeting early perfusate temperatures of ≤10 °C may reduce delayed graft function incidence.
KW - delayed graft function
KW - descriptive comparative
KW - devices
KW - hypothermic machine perfusion
KW - performance improvement
KW - procurement
KW - quality
KW - quantitative methods
KW - regression
KW - research
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U2 - 10.1177/15269248231212920
DO - 10.1177/15269248231212920
M3 - Article
C2 - 37964564
AN - SCOPUS:85176908591
SN - 1526-9248
VL - 33
SP - 341
EP - 347
JO - Progress in Transplantation
JF - Progress in Transplantation
IS - 4
ER -