Introduction: Preservation of Extended Criteria Donors (ECD) with Hypothermic Machine Perfusion (HMP) decreases delayed graft function (DGF) (26 vs 38% with cold storage-CS) and improves 1-year graft survival (1yS). Time of HMP preservation could decrease DGF. Flow (F) and renal resistance (RR) are prognostic factors to assess graft viability.
Objectives: To compare local and imported donors and receptors characteristics, F, RR and functional outcomes.
Materials and Methods: Prospective cohort of fist-graft receptors from 2012, with ≥ 1 year of follow-up. Local ECD were preserved with HMP after kidney recovery. Imported ECD were preserved with CS and HMP (once they arrived at our institution). Vascular thrombosis, acute rejection (AR), DGF and 1yS were assessed.
Results: 119 imported and 74 local grafts. Median age was higher in imported grafts: 76.9 vs 69.2 y.o. No differences in sex, hypertension, BMI, DM and terminal creatinine levels were observed. Cold ischemia time was longer in ECD: 18.4 vs 16.3 h. Relative time of PHM was longer in local ECD: 0.92 vs 0.41. (Table 1)
Median age of imported ECD receptors was higher: 63.2 56.1 y.o. No differences in sex, hypertension, BMI, DM, peripheral vascular and heart disease, kind and time in dialysis were observed. (Table 2)
F increased and RR decreased in both groups at the end of PHM preservation. No differences between groups were observed. (Table 3)
DGF incidence was higher in imported ECD(28.0 vs 18.1%), 1yS was lower in imported ECD (80.3 vs 91.9%). No differences in vascular thrombosis (5.9 vs 5.4), AR (12.3 vs 9.8%) and creatinine clearance at 6 and 12 months (39.4 vs 39.1 ml/m; 41.2 vs 40.5 ml/m) were observed. (Table 4)
Conclusions: PHM reduces the risk of DGF in both groups, compared with DGF rates with CS. DGF reduction is higher in local grafts, with HMP immediately after organ recovery. Shorter cold ischemia time could be another protective factor.