Rescue by Hypothermic Oxygenated Machine Perfusion for Unexpected Long Prolongation of Cold Preservation Time in Expanded Criteria Donor Kidneys Can Achieve Favorable 2‐Year Outcomes
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Wiley
2026
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| author | Silvia Mingozzi Alberto Mella Caterina Dolla Ester Gallo Ana Maria Manzione Enrico Sanna Paolo Randone Rita Tarragoni Roberta Giraudi Gloria Giovinazzo Claudia Melloni Aldo Verri Andrea Bosio Paolo Gontero Antonella Barreca Fabrizio Fop Luigi Biancone |
| author_facet | Silvia Mingozzi Alberto Mella Caterina Dolla Ester Gallo Ana Maria Manzione Enrico Sanna Paolo Randone Rita Tarragoni Roberta Giraudi Gloria Giovinazzo Claudia Melloni Aldo Verri Andrea Bosio Paolo Gontero Antonella Barreca Fabrizio Fop Luigi Biancone Silvia Mingozzi Alberto Mella Caterina Dolla Ester Gallo Ana Maria Manzione Enrico Sanna Paolo Randone Rita Tarragoni Roberta Giraudi Gloria Giovinazzo Claudia Melloni Aldo Verri Andrea Bosio Paolo Gontero Antonella Barreca Fabrizio Fop Luigi Biancone |
| collection | Wiley Open Access |
| contents | Rescue by Hypothermic Oxygenated Machine Perfusion for Unexpected Long Prolongation of Cold Preservation Time in Expanded Criteria Donor Kidneys Can Achieve Favorable 2‐Year Outcomes Silvia Mingozzi Alberto Mella Caterina Dolla Ester Gallo Ana Maria Manzione Enrico Sanna Paolo Randone Rita Tarragoni Roberta Giraudi Gloria Giovinazzo Claudia Melloni Aldo Verri Andrea Bosio Paolo Gontero Antonella Barreca Fabrizio Fop Luigi Biancone Clinical Transplantation ABSTRACT Background Hypothermic oxygenated machine perfusion (HOPE) is occasionally used to overcome logistical issues and allow longer cold preservation time (CPT); however, reports regarding these situations in older brain‐dead donors are lacking. Methods Retrospective analysis of kidney transplants (KTs) performed between January 1, 2015, to December 31, 2023, from extended criteria donors (ECDs) switched to HOPE after a median time of 17.1 h in static cold storage (SCS) for unexpected logistic reasons and with a median total CPT of 28.6 h (25.3–32.0) ( n = 44, HOPE ECDs), compared with a control group of KTs ( n = 44, L‐ECDs) maintained in SCS alone with a low CPT (median, 10.4 h; range, 7.1–11.1) and matched for age, sex, donor age, donor eGFR, pre‐emptive transplant, and cPRA. Results No primary nonfunction was observed, and both death‐censored graft survival (DCGS) and renal function progressively improved, remaining satisfactory and superimposable between groups up to two years post‐transplant (97.7% of DCGS with mean eGFR 46.5 mL/min/1.73 m 2 [36–55.65] in HOPE‐ECDs) versus 97.7% with 42.0 (30.2–48.2) in L‐ECDs with similar KDPI (67% [49.75–86.5] vs. 72.5% [60.5–87.75], p = 0.475). These results were achieved in patients with HOPE‐ECDs, who experienced higher rates of DGF (31.8% vs. 11.4%, p = 0.036). No differences were noted in infection or rejection rates. Conclusion Rescue by HOPE after SCS in ECDs with a very long CPT can achieve midterm outcomes similar to those with a low CPT in SCS alone, paving the way for its safe implementation in clinical practice. 10.1111/ctr.70557 http://creativecommons.org/licenses/by/4.0/ |
| doi_str_mv | 10.1111/ctr.70557 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70557 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Rescue by Hypothermic Oxygenated Machine Perfusion for Unexpected Long Prolongation of Cold Preservation Time in Expanded Criteria Donor Kidneys Can Achieve Favorable 2‐Year Outcomes Silvia Mingozzi Alberto Mella Caterina Dolla Ester Gallo Ana Maria Manzione Enrico Sanna Paolo Randone Rita Tarragoni Roberta Giraudi Gloria Giovinazzo Claudia Melloni Aldo Verri Andrea Bosio Paolo Gontero Antonella Barreca Fabrizio Fop Luigi Biancone Clinical Transplantation Rescue by Hypothermic Oxygenated Machine Perfusion for Unexpected Long Prolongation of Cold Preservation Time in Expanded Criteria Donor Kidneys Can Achieve Favorable 2‐Year Outcomes Silvia Mingozzi Alberto Mella Caterina Dolla Ester Gallo Ana Maria Manzione Enrico Sanna Paolo Randone Rita Tarragoni Roberta Giraudi Gloria Giovinazzo Claudia Melloni Aldo Verri Andrea Bosio Paolo Gontero Antonella Barreca Fabrizio Fop Luigi Biancone Clinical Transplantation ABSTRACT Background Hypothermic oxygenated machine perfusion (HOPE) is occasionally used to overcome logistical issues and allow longer cold preservation time (CPT); however, reports regarding these situations in older brain‐dead donors are lacking. Methods Retrospective analysis of kidney transplants (KTs) performed between January 1, 2015, to December 31, 2023, from extended criteria donors (ECDs) switched to HOPE after a median time of 17.1 h in static cold storage (SCS) for unexpected logistic reasons and with a median total CPT of 28.6 h (25.3–32.0) ( n = 44, HOPE ECDs), compared with a control group of KTs ( n = 44, L‐ECDs) maintained in SCS alone with a low CPT (median, 10.4 h; range, 7.1–11.1) and matched for age, sex, donor age, donor eGFR, pre‐emptive transplant, and cPRA. Results No primary nonfunction was observed, and both death‐censored graft survival (DCGS) and renal function progressively improved, remaining satisfactory and superimposable between groups up to two years post‐transplant (97.7% of DCGS with mean eGFR 46.5 mL/min/1.73 m 2 [36–55.65] in HOPE‐ECDs) versus 97.7% with 42.0 (30.2–48.2) in L‐ECDs with similar KDPI (67% [49.75–86.5] vs. 72.5% [60.5–87.75], p = 0.475). These results were achieved in patients with HOPE‐ECDs, who experienced higher rates of DGF (31.8% vs. 11.4%, p = 0.036). No differences were noted in infection or rejection rates. Conclusion Rescue by HOPE after SCS in ECDs with a very long CPT can achieve midterm outcomes similar to those with a low CPT in SCS alone, paving the way for its safe implementation in clinical practice. 10.1111/ctr.70557 http://creativecommons.org/licenses/by/4.0/ |
| title | Rescue by Hypothermic Oxygenated Machine Perfusion for Unexpected Long Prolongation of Cold Preservation Time in Expanded Criteria Donor Kidneys Can Achieve Favorable 2‐Year Outcomes |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70557 |