University of Wisconsin (UW) preservation
solution has been reported to be beneficial for canine organ transplants and for human liver and pancreas transplants. To examine whether it affects renal graft survival, a randomised multicentre trial was conducted to compare its effect with that of
EuroCollins solution on
delayed graft function, renal function, and patient and graft survival in 695 recipients of cadaveric renal transplants. 352 kidneys were preserved with UW and 343 with
EuroCollins solution.
Delayed graft function occurred in 23% of the UW group and in 33% of the EuroCollins group (p = 0.003). Three factors other than type of preservation fluid were associated with a higher incidence of
delayed graft function: older donor age, intracerebral haemorrhage in the donor, and
oliguria in the donor. Renal function as indicated by serum
creatinine concentration was better in the UW than in the EuroCollins group. Patient survival in the UW and EuroCollins groups after 1 year was 95% and 94%, respectively. In both groups,
delayed graft function reduced 1-year graft survival by 15% (p = 0.0001). 1-year graft survival of UW-preserved kidneys was 6% higher than that of controls (88.2% vs 82.5%, p = 0.04).
Delayed graft function is significantly associated with a reduction in 1-year graft survival. The preservation
solution is the most important factor influencing development of
delayed graft function, and
UW solution is superior to
EuroCollins solution in reducing occurrence of
delayed graft function, improving graft function, extending graft survival.