MACHINE PULSATILE PERFUSION PARAMETERS AND HISTOLOGICAL FINDINGS FROM A MULTICENTER RANDOMIZED CONTROLLED TRIAL OF THROMBOLYTIC THERAPY FOLLOWING DCD KIDNEY DONATION

Kidneys from donors after cardiac death (DCD) are at risk for inferior outcomes, possibly due to micro-thrombi and additional warm ischemia. We describe the preservation and biopsy findings from an organ procurement organization-wide trial utilizing thrombolytic tissue plasminogen activator (tPA) during machine pulsatile perfusion (MPP), which had shown promising DGF trends for those receiving tPA-pumped kidneys. Following DCD donation, a kidney from each recovered pair was prospectively randomized to receive tPA (50mg Alteplase) or no tPA (control) in the MPP perfusate. Pre- and post-MPP biopsies were obtained. While the tPA benefit during MPP was suggested by decreased DGF rates, MPP parameter differences or post-MPP histology differences between the groups were not apparent. Nevertheless, as increased DCD kidney utilization has the potential to impact the organ shortage, a larger trial is warranted.