Navigation Links
A Better Method of Kidney Storage
Date:12/31/2008

Continuous pumping of solution through donated organ improved odds, study shows

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.

"To pump a kidney costs about $1,000 to $1,500," Fung said. "Is that added cost going to be offset by the benefits? If you look at the data, the reduced cost of dialysis and better survival at one year, they didn't answer that question."

The study will not change the Cleveland Clinic's use of perfusion, which is limited, Fung said. "We use cold storage for most kidneys," he said. "We use the pump for those kidneys we are not so sure about -- from older donors, those where the kidney function may not be as good, for example. We're selective about it."

And the study will not change the practice at Mount Sinai, which is governed by the rules of the New York Organ Donor Network, Bromberg said. "The overwhelming majority of kidneys transplanted in New York have been on the machine," he said. "Every now and then, we don't use it."

Still, the study does not provide definitive evidence about whether perfusion is necessary for all donated kidneys, Bromberg said.

The practice in New England is to use perfusion for "extended-criteria" kidneys, such as those from older donors or donors whose heart stopped beating before the kidney was removed, said Dr. Stefan G. Tullius, chief of transplant surgery at Brigham and Women's Hospital in Boston, who wrote an editorial accompanying the journal report.

"We will continue to do that," Tullius said. "But there will be greater emphasis on using perfusion with the report of this clinical trial."

The study showed "a significant reduction of delayed organ function, which is certainly a very unique finding, and this is the first trial showing it," Tullius said.

More information

The basics of kidney transplantation are described by the U.S. National Library of Medicine.



SOURCES: Jonathan Bromberg, M.D., chairman, Mount Sinai Medical Center Transplant Institute, New York City; John Fung, M.D., director, transplant services, Cleveland Clinic; Stefan G. Tullius, M.D., chief, transplant surgery, Brigham and Women's Hospital, Boston; Jan. 1, 2009, New England Journal of Medicine


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Walk Your Way to Better Health in 2009
2. New Product Makes Loose Dentures Fit Better
3. Coated Stents Better Than Bare Metal Ones in Short Run
4. Better patient outcomes with drug eluting stents
5. National rates of co-occurring substance use and mental disorders call for better service integration
6. Lower-dose fractionated stereotactic radiotherapy results in better hearing preservation
7. Immune System Works Better at Night
8. AmericInn Hotels Partners With Nationally Recognized Sleep Expert Dr. Christopher Drake, Announces Launch of Sleep Better America Campaign
9. Immunology Center will continue to drive standard methods, better science
10. Most Newer Antipsychotics No Better Than Older Ones, Just Different
11. Southern California Rehabilitation Clinic is Hiring Bilingual Therapists to Better Serve the Hispanic Communities of Mexico and the United States
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
A Better Method of Kidney Storage
(Date:5/3/2016)... ... May 03, 2016 , ... Finding the right way to address a patient’s condition before it ... now getting on board. , “You do the right thing, at the right time, at ... down, not up,” said Leonard M. Fromer, MD, FAAFP, from Group Practice Forum. “Even if ...
(Date:5/3/2016)... ... 2016 , ... Dave Newberry, broker/owner of Newberry Realty, recently announced his office ... luncheon on Friday, May 20. “We have raised over $1,000 for the table to ... Newberry. , PICC is a local Kent, WA, clinic that cares for drug-exposed babies ...
(Date:5/2/2016)... ... 02, 2016 , ... It has just been announced Jack Uldrich, ... throughout the month of May. , Uldrich is the author of 11 books and ... frequently appears on the Science Channel’s FutureScape and Discovery Channel’s Inside Out. , Known ...
(Date:5/2/2016)... ... May 02, 2016 , ... As directed by its ... Pennsylvania (HAP) issues its full support to allow certified nurse practitioners (CNP) to practice ... they have worked under such supervision for three years and 3,600 hours. , In ...
(Date:5/2/2016)... ... May 02, 2016 , ... Eating Recovery Center’s Insight Behavioral ... and anxiety disorders, has rebranded its eating disorder program under a new name: Eating ... treatment facility on May 16. , To celebrate, ERC Chicago will host a ...
Breaking Medicine News(10 mins):
(Date:4/28/2016)... April 28, 2016 Oramed Pharmaceuticals Inc. ... pharmaceutical company focused on the development of oral drug delivery ... upcoming PIONEERS 2016 conference, presented by Joseph Gunnar ... New York . Nadav Kidron , ... conference. Presentation Details:   PIONEERS ...
(Date:4/27/2016)... April 27, 2016  Hologic, Inc. (Nasdaq: ... results for the fiscal second quarter ended March ... of $0.24 increased 41.2%, and non-GAAP diluted EPS ... increased 5.8% on a reported basis, and 6.3% ... "We posted another good quarter, highlighted by 14.6% ...
(Date:4/27/2016)... Transparency Market Research has published ... Global Industry Analysis, Size, Share, Growth, Trends, and Forecast ... skincare devices market was valued at US$ 7,255.8 Mn ... CAGR of 10.1% from 2015 to 2023 to reach ... full Skincare Devices Market (Treatment Device - LED Therapy Devices, ...
Breaking Medicine Technology: