The impact of preservation solutions for static cold storage on kidney transplantation outcomes: Results of a Brazilian nationwide multicenter study

• Published in: PloS one Vol. 19; no. 7; p. e0306056
• Main Authors: Sandes-Freitas, Tainá Veras de, Moura, Lucio Requião, Carvalho, Deise Rosa de Boni Monteiro de, Garcia, Valter Duro, Modelli de Andrade, Luis Gustavo, Mazzali, Marilda, Manfro, Roberto Ceratti, Deboni, Luciane Mônica, Davi-Neto, Elias, Oliveira, Claudia Maria Costa de, Cavalcanti, Frederico Castelo Branco, Madeira, Rafael Lage, Esmeraldo, Ronaldo de Matos, Simão, Denise Rodrigues, Meira, Ana Carolina Guedes, Ferreira, Gustavo Fernandes, Lasmar, Marcus, Bignelli, Alexandre Tortoza, Pacheco-Silva, Alvaro, Medina Pestana, José, Tedesco Silva, Hélio
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 05-07-2024; Public Library of Science (PLoS)
• Subjects: Adult; Biology and Life Sciences; Brazil - epidemiology; Cold storage; Cryopreservation; Delayed Graft Function - epidemiology; Demographics; Dialysis; Female; Graft Survival - drug effects; Grafting; Hemodialysis; Histidine; Humans; Informed consent; Ischemia; Kidney transplantation; Kidney Transplantation - methods; Kidney transplants; Kidneys; Length of stay; Male; Medicine and Health Sciences; Middle Aged; Organ Preservation - methods; Organ Preservation Solutions; Organ transplant recipients; Patients; People and places; Physical Sciences; Retrospective Studies; Statistical analysis; Survival; Transplantation; Transplants; Tryptophan; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0306056

This study evaluated the current practices of selecting cold storage preservation solutions in Brazil and their impact on delayed graft function (DGF) incidence and 1-year outcomes in kidney transplant recipients. A retrospective cohort study was conducted, including 3,134 brain-dead deceased donor kidney transplants performed between 2014 and 2015 in 18 Brazilian centers. The most commonly used preservation solution was Euro-collins (EC, 55.4%), followed by Histidine-tryptophan-ketoglutarate (HTK, 30%) and Institut Georges Lopez (IGL-1, 14.6%). The incidence of DGF was 54.4%, with 11.7% of patients requiring dialysis for more than 14 days, indicating prolonged DGF. Upon adjusting for confounding variables, HTK demonstrated a significantly lower risk of DGF than EC (OR 0.7350.82500.926), as did IGL-1 (OR 0.6050.7120.837). Similar protective effects were observed for prolonged DGF when comparing HTK (OR 0.4780.5990.749) and IGL-1 (OR 0.4780.6810.749) against EC. No significant association was found between preservation solutions and 1-year death-censored graft survival. In conclusion, EC was the most frequently used cold storage perfusion solution, demonstrating a higher incidence and duration of DGF compared with HTK and IGL-1, but with no impact on 1-year graft survival.