Machine Measured Renal Resistance (MMRR) is the most sensitive tool for prediction of early renal allograft survival.

Studies have recognized the relationship among renal allograft resistance, graft function and survival. The relationship of MMRR and chronic allograft pathology remains unstudied.

Method

Method: We performed a retrospective analysis of 1181 deceased donor kidneys transplanted in a large donor service area (DSA) from 2007-2009. All kidneys were evaluated using MMRR and Optimized Needle Biopsy Technique protocol. All biopsies were frozen section evaluations performed by a single transplant pathology laboratory for the DSA. The pathology report identified the following renal allograft parameters: 1. Total number of glomeruli/number of obsolete glomeruli (GS); 2. Tubular interstitial scarring (TIS); 3. Intimal fibrous narrowing of arteries (IFN). MMRR was measured after 3 hours of machine perfusion based on previous studies indicating this is the earliest time to predict a difference in graft survival by MMRR cohorts. Based upon MMRR, allografts were separated into three groups: < 0.2, 0.2-0.3, >0.3. Renal function at 1 year was measured using e-GFR (MDRD). ANOVA was used to correlate pre-transplant MMRR with GS, TIS, IFN and 1-year recipient e-GFR.