Published in The Lancet, this multicentre, double-blinded, randomized controlled trial (RCT) studied the effect of supplemental oxygen during hypothermic machine perfusion of kidneys donated after circulatory death (DCD)* . In this paired analysis, resulting in the transplantation of 106 kidney pairs, one kidney from each donor was randomly assigned to hypothermic oxygenated machine perfusion (HOPE) while the contralateral kidney was assigned to non-oxygenated hypothermic machine perfusion (HMP). The study demonstrates that HOPE with the Kidney Assist Transport significantly improves renal function (eGFR: 47.6 vs 42.6 ml/min/1.73m2; p=0.035) and graft survival (3% vs 10%; p=0.028) up to 1-year post-Tx, and reduces the risk of biopsy-proven acute rejection by 44% (14% vs 26%; p=0.040) compared to non-oxygenated HMP. Also, recipients of HOPE-treated kidneys experienced fewer serious post-operative complications (Clavien-Dindo grade ≥IIIb) than their contralateral non-oxygenated counterparts (11% vs 16%; p=0.032). The authors conclude that HOPE confers a clinically relevant benefit compared with standard HMP.
“Given that the cost for additional oxygen is low and the benefits for patients appear considerable, this new and rather simple extension to the current preservation strategy has the potential for quick implementation in clinical practice to improve patient outcomes and reduce health-care costs.”
Jochmans et al 2020
The Lancet / 2020 / doi: 10.1016/S0140-6736(20)32411-9
*Inclusion was limited to kidney pairs procured from controlled DCD donors ≥ 50 years.
