A Better Method of Kidney Storage

ByABC News
December 31, 2008, 11:01 PM

Jan. 1 -- WEDNESDAY, Dec. 31 (HealthDay News) -- Pumping a solution continuously through a donated kidney raised the chances of a successful transplant when compared to simple cold storage of the organ, European researchers report.

The study, published in the Jan. 1 issue of the New England Journal of Medicine, got generally favorable reviews from American transplant experts.

It was hailed as "a landmark study" by Dr. Jonathan Bromberg, chairman of the Mount Sinai Medical Center Transplant Institute in New York.

"Machine perfusion has been performed for upwards of 20 years, and there has been a general perception among people in the field that it might do several important things -- better preservation of the kidney, clearing away toxins, giving data on whether the kidney is any good," Bromberg said. "But all the data until this have come from small, single-center retrospective studies. This is the largest and far away best to be done."

The European study, led by Dutch physicians, compared results of 336 transplants in which the donated kidney was subjected to hyperthermic machine perfusion to the same number in which the organs were kept in cold storage. Overall, the perfused kidneys did better once transplanted.

Delayed function of the transplanted kidney that required dialysis was seen in 70 cases where the organ was perfused, compared to 89 cases in the cold-storage group. Lower serum creatinine levels, a measure of better kidney function, was more common in the perfused organs. The one-year success rate for perfused organs was 94 percent, compared to 90 percent for the cold-storage group.

"This is clearly the best paper around," Bromberg said. "But you really have to look at the details and analysis of subsets of patients, and also at the economics. The study was not large enough to enable a subset analysis, and there was no economic or financial analysis at all."

Dr. John Fung, director of transplant services at the Cleveland Clinic, did his own financial analysis, which was not favorable for perfusion.