1. 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

2. BACKGROUND Number of donors in the UK

3. BACKGROUND Age of deceased donors in the UK

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

5. Prospective, non-randomized observational study From 1 Jan 2011 to 31 May 2012 69 consecutive DCD kidney transplants Excluded Double kidney transplants Kidney-pancreas transplants METHOD

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

7. 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

8. RESULTS HMP (n=42) CS (n=27) p Donor age 58.21± 15.4959.87 ± 10.710.629 Donor creatinin e 69.50 ± 19.2273.52 ± 22.500.431 Recipien t age 59.06 ± 12.1260.66 ± 11.400.587 CIT14.73 ± 4.509.90 ± 4.67<0.001

9. Odds ratio 3.85 INCIDENCE OF DGF

10. dDGF fDGF LOGISTIC REGRESSION BS.E.pExp(B) Donor age 0.0360.0210.0931.036 CIT 0.0490.0630.4441.050 MP / CS 1.7170.6480.0085.565 Constant 3.3181.5830.036 BS.E.pExp(B) Donor age 0.0520.0220.0161.053 CIT 0.072 0.3211.074 MP / CS 0.9970.7200.1662.710 Constant 3.2921.6700.0490.037

11. GFR

12. GFR @ 1 Month MULTIPLE REGRESSION Unstandardized Coefficients Standardized Coefficients tp BStd. ErrorBeta (Constant)92.6079.016 10.271<0.001 Donor age0.7700.1330.5505.798<0.001 CIT1.0590.4020.2812.6310.011 MP / CS11.0264.1880.2812.6330.011

13. 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