PABLO DOMÉNECH LÓPEZ, CARMİNA MUÑOZ BASTİDAS, JUAN COLOMBÁS VİVES, CRİSTİNA GUTİÉRREZ CASTAÑÉ, SANTİAGO CHİVA SAN ROMÁN, FRANCİSCO JAVİER ANCİZU MARCKERT, JOSE ENRİQUE ROBLES GARCÍA
Experimental and Clinical Transplantation - 2024;22(11):843-849
Objectives: With the increase in life expectancy and the aging of the population, chronic kidney disease has become increasingly prevalent in our environment. Kidney transplant remains the gold standard treatment for end-stage renal disease, but the supply of renal grafts has not been able to keep pace with growing demands. Thus, organ selection criteria have been extended, and expanded criteria donation and alternative donation types, such as donation after circulatory death, have been evaluated. Although these approaches can increase the pool of potential donors, organs have potentially lower quality. Diverse strategies have been explored to enhance graft function with organs from donors after circulatory death, with one of the most promising being the utilization of pulsatile machine perfusion. Materials and Methods: We conducted a retrospective analysis of 28 recipients who met the inclusion criterion of sharing the same donor, wherein one organ was preserved by cold storage and the other by pulsatile machine perfusion. We performed statistical analysis on posttransplant recovery parameters throughout the patients’ hospitalization, including admission and discharge phases. Results: Significant differences were noted in delayed graft function (P = .04) and in blood transfusions requirements and Clavien-Dindo complications. Furthermore, discharge parameters and hospital stay showed notable overall trends of improvement in favor of the pulsatile machine perfusion group. Conclusions: The use of pulsatile machine perfusion as a method of renal preservation results in graft optimization, leading to earlier recovery and fewer complications compared with cold storage in the context of donation after circulatory death.
