Eurotransplant randomized multicenter kidney graft preservation study comparing HTK with UW and Euro-Collins

The aim was to evaluate the effect of HTK compared to UW and Euro-Collins ( EC) on the initial graft function and long term graft survival in two prosp ective randomized studies. Only kidneys from heart-beating, kidney-only or kidney + heart donors were eligible for entry. Initial non-function (INF) w as defined as the absence of life-sustaining renal function, requiring dial ysis treatment on two or more occasions, during the first week after transp lantation. To evaluate the contribution of the preservation solutions on IN F in relation to other factors, a multivariate, 2-step logistic regression model was used. Randomization was performed between July 1990 and September 1992. The UW-HTK study comprised 342 donors and 611 transplants (UW: 168 d onors and 297 transplants, HTK: 174 donors and 314 transplants). In the EC- HTK study 317 donors and 569 transplants were included (EC: 155 donors and 277 transplants, HTK: 162 donors and 292 transplants). INF occurred in 33 % of either HTK-(n = 105) or UW-(n = 99) preserved kidneys (P = NS), and in 29% of the HTK-(n = 85) and in 43 % of the EC-(n = 119) preserved kidneys ( P = 0.001). Multivariate analysis showed no significant influence of the pr eservation solution on the incidence of INF in the UW-HTK study, but factor s contributing to INF were donor age, cause of death, retransplantation, an d cold ischemic period. The EC-HTK study showed a significantly higher risk of INF, using EC as preservation, in addition to cold ischemic period and donor quality. The 3-year graft survival of HTK-preserved kidneys was 73 %, compared to 68 % for UW-preserved kidneys in the UW-HTK study (P = NS); wh ile the 3-year graft survival of HTK preserved kidneys was 70 % compared to 67 % for EC-preserved kidneys in the EC-HTK study (P = NS). We can conclud e that HTK is comparable to UW in its preservative abilities, using kidneys from heart-beating kidney-only donors, whereas EC as renal preservation so lution should be avoided.