Abstract：
OBJECTIVE: With the increase in life expectancy and the aging of the population, chronic kidney disease has become increasingly prevalent in our environment. Kidney transplantation remains the gold standard treatment for end-stage renal disease, but the supply of renal grafts has not been able to keep pace with growing demand. Because of this rationale, organ selection criteria have been extended (expanded criteria donation), and alternative donation types, such as donation after circulatory death, have been evaluated. These approaches aim to increase the pool of potential donors, albeit with organs of potentially lower quality. Various forms of donations, including donation after circulatory death, have also undergone assessment. This approach aims to augment the pool of potential donors, notwithstanding the compromised quality of organs associated with such methods. Diverse strategies have been explored to enhance graft function, with one of the most promising being the utilization of pulsatile machine perfusion.
METHODS: We conducted a retrospective analysis on 28 transplant recipients who met the inclusion criterion of sharing the same donor, wherein one organ was preserved by cold storage and the other by pulsatile machine perfusion. We performed statistical analysis on posttransplant recovery parameters throughout the patients\' hospitalization, including admission and discharge phases.
RESULTS: Statistically significant differences were noted in delayed graft function (P = .04), blood transfusions requirements, and Clavien-Dindo complications. Furthermore, an overall trend of improvement in discharge parameters and hospital stay was in favor of the pulsatile machine perfusion group.
CONCLUSIONS: The use of pulsatile machine perfusion as a method of renal preservation results in graft optimization, leading to earlier recovery and fewer complications compared with cold storage in the context of donation after circulatory death.
METHODS: We conducted a retrospective analysis on 28 transplant recipients who met the inclusion criterion of sharing the same donor, wherein one organ was preserved by cold storage and the other by pulsatile machine perfusion. We performed statistical analysis on posttransplant recovery parameters throughout the patients\' hospitalization, including admission and discharge phases.
RESULTS: Statistically significant differences were noted in delayed graft function (P = .04), blood transfusions requirements, and Clavien-Dindo complications. Furthermore, an overall trend of improvement in discharge parameters and hospital stay was in favor of the pulsatile machine perfusion group.
CONCLUSIONS: The use of pulsatile machine perfusion as a method of renal preservation results in graft optimization, leading to earlier recovery and fewer complications compared with cold storage in the context of donation after circulatory death.
摘要：
目标：随着预期寿命的增加和人口老龄化，慢性肾脏病在我们的环境中越来越普遍。肾移植仍是治疗终末期肾病的金标准,但是肾移植物的供应未能跟上需求的增长。因为这个理由，器官选择标准已经扩大(扩大标准捐赠)，和替代捐赠类型，例如循环系统死亡后的捐赠，已被评估。这些方法旨在增加潜在捐助者的数量，尽管器官质量可能较低。各种形式的捐赠，包括循环系统死亡后的捐赠，也进行了评估。这种方法旨在扩大潜在捐助者的数量，尽管与这种方法相关的器官质量受损。已经探索了多种策略来增强移植物功能，其中最有前途的是利用脉动机灌注。
方法：我们对28位符合同一供体纳入标准的移植受者进行了回顾性分析，其中一个器官通过冷藏保存，另一个通过脉动机灌注保存。我们对整个患者住院期间的移植后恢复参数进行了统计分析，包括入院和出院阶段。
结果：在延迟移植物功能方面存在统计学上的显着差异（P=0.04），输血需求,还有Clavien-Dindo并发症.此外，出院参数和住院时间的总体改善趋势有利于脉动机灌注组。
结论：使用脉动机灌注作为肾脏保存方法可以优化移植物，与循环死亡后捐赠的冷藏相比，导致更早的恢复和更少的并发症。
方法：我们对28位符合同一供体纳入标准的移植受者进行了回顾性分析，其中一个器官通过冷藏保存，另一个通过脉动机灌注保存。我们对整个患者住院期间的移植后恢复参数进行了统计分析，包括入院和出院阶段。
结果：在延迟移植物功能方面存在统计学上的显着差异（P=0.04），输血需求,还有Clavien-Dindo并发症.此外，出院参数和住院时间的总体改善趋势有利于脉动机灌注组。
结论：使用脉动机灌注作为肾脏保存方法可以优化移植物，与循环死亡后捐赠的冷藏相比，导致更早的恢复和更少的并发症。
