L. Szabo B. Cook A. Asderakis E. Ablorsu Cardiff Transplant Unit Cardiff UK HYPOTHERMIC MACHINE PERFUSION IMPROVES OUTCOMES IN DCD KIDNEYS WITH LONG COLD ISCHEMIA TIME

BACKGROUND Number of donors in the UK

BACKGROUND Age of deceased donors in the UK

To assess the effect of hypothermic pulsatile machine perfusion (MP) on the early function of DCD kidneys AIM

Prospective, non-randomized observational study From 1 Jan 2011 to 31 May consecutive DCD kidney transplants Excluded Double kidney transplants Kidney-pancreas transplants METHOD

Assessed parameters Donor age, CIT, type of storage (MP v CS) Outcomes 1 month dDGF (need of HD), fDGF (functional) METHOD

DCD kidneys are allocated locally in the UK In our centre DCD kidneys are transplanted without Xmatch to an antibody negative patient (virtual XM) MP (n=42) if any delay occurred and long CIT was anticipated 2 nd kidney if a pair was allocated to our centre CS (n=27) Short CIT, no delay ALLOCATION OF DCD KIDNEYS

RESULTS HMP (n=42) CS (n=27) p Donor age 58.21± ± Donor creatinin e ± ± Recipien t age ± ± CIT14.73 ± ± 4.67<0.001

Odds ratio 3.85 INCIDENCE OF DGF

dDGF fDGF LOGISTIC REGRESSION BS.E.pExp(B) Donor age CIT MP / CS Constant BS.E.pExp(B) Donor age CIT MP / CS Constant

GFR

1 Month MULTIPLE REGRESSION Unstandardized Coefficients Standardized Coefficients tp BStd. ErrorBeta (Constant) <0.001 Donor age <0.001 CIT MP / CS

MP, on DCD kidneys, can neutralize the adverse effect of the long CIT, leading to at least equivalent early graft function (GFR), lower rates of dDGF CONCLUSION