Meta-Analysis and Clinical Guidance of Oxygenated Hypothermic Machine Perfusion for Kidney Transplantation

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-04-30 DOI:10.1016/j.transproceed.2025.03.006

Degong Jia , Shanshan Guo , Jiefu Luo , Yuezhou Zhang , Huiqing Zhang , Shengwei , Junyan Liu

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引用次数: 0

Abstract

Background

It remains unclear whether oxygenated hypothermic machine perfusion (HMPO₂) during kidney preservation is beneficial for prognosis.

Methods

A comprehensive search of databases and clinical trial registries was conducted to identify eligible studies on HMPO₂ application during kidney transplantation. A multisubgroup analysis was further conducted to explore the heterogeneity among studies.

Results

Compared to the control treatment, HMPO₂ did not significantly alter the incidence of postoperative acute rejection, graft survival, patient mortality, delayed graft function (DGF), functional DGF, primary nonfunction, or estimated glomerular filtration rate, whereas the warm ischemia time appeared to be longer. However, the number of patients with adverse events and the proportion of severe adverse events were reduced in the HMPO₂ group. Subgroup analysis indicated that HMPO₂ performed better in donation after cardiac death (DCD), and continuous HMPO₂ was superior to end-HMPO₂.

Conclusion

HMPO₂ application during kidney transplantation reduced the number of patients with adverse events and the proportion of severe adverse events. However, given the issue such as limited number of studies and heterogeneity, rigorous evidence studies are needed to further confirm these findings.

查看原文本刊更多论文

氧合低温机灌注治疗肾移植的meta分析及临床指导。

背景：肾保存期间氧合低温机灌注（HMPO2）是否有利于预后尚不清楚。方法：对数据库和临床试验注册进行全面检索，以确定HMPO2在肾移植中的应用。进一步进行多亚组分析以探讨研究间的异质性。结果：与对照组相比，HMPO2没有显著改变术后急性排斥反应发生率、移植物存活率、患者死亡率、移植物延迟功能（DGF）、功能性DGF、原发性无功能或肾小球滤过率，而热缺血时间似乎更长。然而，HMPO2组出现不良事件的患者数量和严重不良事件的比例均有所减少。亚组分析表明，心脏死亡（DCD）后捐献HMPO2表现较好，持续HMPO2优于末端HMPO2。结论：肾移植过程中应用HMPO2可减少不良事件发生人数和严重不良事件发生比例。然而，考虑到研究数量有限和异质性等问题，需要严格的证据研究来进一步证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.