Renal Preservation

Currently, there are two methods of preserving kidneys for transplantation: static cold storage or continuous machine perfusion. The majority of centers use cold storage due to simplicity but experience a higher rate of delayed graft function (DGF) than with machine perfusion. Although previously not thought to be important, early DGF appears to predict long-term graft survival. Also, with more expanded donors being utilized, including DCD donors, continuous machine perfusion may be beneficial in preserving organ function. The machine perfusion solution is similar to UW cold storage solution except that lactobionate is replaced by gluconate. As a general rule, cold-stored kidneys should be implanted within 18-24 hours and machine-perfused kidneys within 24-30 hours of removal.

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