A Paul

The Prognostic Value of Renal Resistance During Hypothermic Machine Perfusion of Deceased Donor Kidneys

Vascular renal resistance (RR) during hypothermic machine perfusion (HMP) is frequently used in kidney graft quality assessment. However, the association between RR and outcome has never been prospectively validated. Prospectively collected RR values of 302 machine‐perfused deceased donor kidneys of all types (standard and extended criteria donor kidneys and kidneys donated after cardiac death), transplanted without prior knowledge of these RR values, were studied. In this cohort, we determined the association between RR and delayed graft function (DGF) and 1‐year graft survival. The RR (mmHg/mL/min) at the end of HMP was an independent risk factor for DGF (odds ratio 21.12 [1.03–435.0]; p = 0.048) but the predictive value of RR was low, reflected by a c‐statistic of the receiver operator characteristic curve of 0.58. The RR was also found to be an independent risk factor for 1‐year graft failure (hazard ratio 12.33 [1.11–136.85]; p = 0.004). Determinants of transplant outcome are multifactorial in nature and this study identifies RR as an additional parameter to take into account when evaluating graft quality and estimating the likelihood of successful outcome. However, RR as a stand‐alone quality assessment tool cannot be used to predict outcome with sufficient precision.

Cost‐Effectiveness of Hypothermic Machine Preservation Versus Static Cold Storage in Renal Transplantation

Static cold storage (CS) is the most widely used organ preservation method for deceased donor kidney grafts but there is increasing evidence that hypothermic machine perfusion (MP) may result in better outcome after transplantation. We performed an economic evaluation of MP versus CS alongside a multicenter RCT investigating short‐ and long‐term cost‐effectiveness. Three hundred thirty‐six consecutive kidney pairs were included, one of which was assigned to MP and one to CS. The economic evaluation combined the short‐term results based on the empirical data from the study with a Markov model with a 10‐year time horizon. Direct medical costs of hospital stay, dialysis treatment, and complications were included. Data regarding long‐term survival, quality of life, and long‐term costs were derived from literature. The short‐term evaluation showed that MP reduced the risk of delayed graft function and graft failure at lower costs than CS. The Markov model revealed cost savings of

The Prognostic Value of Renal Resistance During Hypothermic Machine Perfusion of Deceased Donor Kidneys (vol 11, pg 2214, 2011)

86 750 per life‐year gained in favor of MP. The corresponding incremental cost‐utility ratio was minus

Long Term Cost-Effectiveness of Hypothermic Machine Perfusion Versus Static Cold Storage in Kidney Transplantation.

496 223 per quality‐adjusted life‐year (QALY) gained. We conclude that life‐years and QALYs can be gained while reducing costs at the same time, when kidneys are preserved by MP instead of CS.

COST-EFFECTIVENESS OF HYPOTHERMIC MACHINE PERFUSION VERSUS STATIC COLD STORAGE IN KIDNEY TRANSPLANTATION: FIRST RESULTS OF THE PROSPECTIVE EUROPEAN RCT: 265

Due to an error in the abstract of the following article, the odds ratio of vascular renal resistance for the development of delayed graft function in deceased donor machine-perfused kidneys is incorrect. The Prognostic Value of Renal Resistance During Hypothermic Machine Perfusion of Deceased Donor Kidneys Jochmans I, Moers C, Smits JM, Leuvenik HGD, Treckmann J, Paul A, Rahmel A, Squifflet JP, van Heurn E, Monbaliu D, Ploeg RJ, Pirenne J Am J Transplant 2011; 11: 2214–2220. doi: 10.1111/j.1600-6143.2011.03685.x The odds ratio of vascular renal resistance for the development of delayed graft function in deceased donor machineperfused kidneys should read 38.1 (1.56–934); p = 0.026. The main body of the article is correct and the interpretations and conclusions of the study do not change. The authors apologize for the error and regret any inconvience that it may have caused.