Effect of preservation solutions for static cold storage on kidney transplantation outcomes: A National Registry Study

This study aimed to evaluate how 5 preservation solutions for static cold storage affected kidney transplant outcomes. It included all first single kidney transplants during 2010‐2014 from donations after brain death in the French national transplant registry, excluding preemptive transplants and transplants of kidneys preserved with a hypothermic perfusion machine. The effects of each preservation solution on delayed graft function (DGF) and 1‐year transplant failure were evaluated with hierarchical multivariable logistic regression models. The study finally included 7640 transplanted kidneys: 3473 (45.5%) preserved with Institut Georges Lopez‐1 solution (IGL‐1), 773 (10.1%) with University of Wisconsin solution, 731 (9.6%) with Solution de Conservation des Organes et Tissus (SCOT, organ and tissue preservation solution), 2215 (29.0%) with Celsior, and 448 (5.9%) with histidine–tryptophan–ketoglutarate. Primary nonfunction rates did not differ by solution. After adjustment for donor, recipient, and transplant characteristics, the DGF risk was significantly lower with IGL‐1 than with all other solutions (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.48‐0.64). Conversely, SCOT was associated with a DGF risk significantly higher than the other solutions (OR 2.69, 95% CI 2.21‐3.27) and triple that of IGL‐1 (OR 3.37, 95% CI 2.72‐4.16). One year after transplantation, the transplant failure rate did not differ significantly by preservation solution. The difference between the groups for 1‐year mean creatinine clearance was not clinically relevant. This study compares outcomes in a French multicenter cohort of donation after brain death kidney transplants according to the 5 preservation solutions used for static cold storage, showing that preservation solution type was associated with differential risk of delayed graft function but not 1‐year graft survival.