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Pulsatile perfusion of kidney allografts

Matsuoka, Lea; Almeda, Jose L; Mateo, Rod

Current Opinion in Organ Transplantation: August 2009 - Volume 14 - Issue 4 - p 365–369
doi: 10.1097/MOT.0b013e32832dbd1c
Renal transplantation: Edited By Yasir Qazi
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Purpose of review The purpose of this article is to describe the current use of pulsatile kidney perfusion during organ preservation and the effects on kidney allograft outcomes and utilization.

Recent findings As of spring 2008, there were 75 629 candidates on the kidney waiting list in the USA according to United Network for Organ Sharing data. In 2006, a total of 1815 deceased donor expanded criteria donors kidneys were transplanted, and approximately 80% of those kidneys had cold ischemic time of over 12 h. The utilization of kidney pulsatile perfusion varies extensively throughout the USA with rates of 7–12% in our institution.

Summary Data on the use of pulsatile hypothermic perfusion for kidneys during organ preservation are limited and mostly retrospective. Most authors agree that pulsatile perfusion is safe and leads to a decrease in delayed graft function, especially for marginal kidneys from extended criteria or deceased donors. The long-term effects of delayed graft function on graft survival remain to be seen. With the recent large-sampled international prospective randomized trial recently completed, we may see more kidneys pulsatile perfused. This may lead to an increase in the utilization of otherwise discarded kidneys, though these data are difficult to extrapolate.

Abdominal Organ Transplantation Division, Keck School of Medicine, University of Southern California, Los Angeles, California, USA

Correspondence to L. Matsuoka, MD, Fellow, 1510 San Pablo, Suite 200, Los Angeles, CA 91101, USA Tel: +1 323 442 6840; e-mail: lmatsuoka@surgery.usc.edu

© 2009 Lippincott Williams & Wilkins, Inc.