1. L. Szabo P. Laftsidis E. Ablorsu Cardiff Transplant Unit Cardiff UK HYPOTHERMIC MACHINE PERFUSION IMPROVES OUTCOMES IN DCD KIDNEYS

2. _________ _________ BACKGROUND

3. To assess the effect of hypothermic pulsatile machine perfusion (MP) on the early function of DCD kidneys To evaluate the correlation between perfusion parameters and early graft function AIM

4. Prospective, non-randomized observational study From 1 Jan 2010 to 10 June 2013 155 consecutive DCD kidney transplants Excluded Double kidney transplants Kidney-pancreas transplants Assessed parameters Donor age, CIT, type of storage (MP v CS) Outcomes eGFR @ 1 month Functional DGF METHOD

5. RESULTS

7. Donor age, CIT and type of storage correlated with fDGF @ 1, 3 and 6 months donor age, CIT, and type of storage showed significant correlation with the eGFR. @ 1 and 2 years only the donor age correlated significantly with the eGFR. Perfusion parameters, CIT and starting resistance were found to correlate significantly with DGF (Exp(B)=1.17 and 21.26 respectively, p=0.05) REGRESSION ANALYSIS pExp(B) Donor age0.0381.09 CIT0.0311.114 MP / CS0.432.50 Constant0.0490.037

8. SURVIVAL

9. MP, on DCD kidneys, can neutralize the adverse effect of the long CIT, leading to at least equivalent early graft function (GFR), Start resistance correlates with DGF. No difference in long term function and survival. CONCLUSION

10. 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=64) if any delay occurred and long CIT was anticipated 2 nd kidney if a pair was allocated to our centre CS (n=91) Short CIT, no delay ALLOCATION OF DCD KIDNEYS

11. HMP (n=42) CS (n=27) p Donor age 58.02± 15.32 56.64 ± 13.65 0.558 Donor creatinin e 76.36 ± 35.74 81.25 ± 36.30 0.406 Recipient age 58.65 ± 12.25 57.94 ± 12.30 0.726 CIT 14.76 ± 4.14 11.48 ± 4.17 <0.001