Machine perfusion (MP) has been used as the kidney preservation method in our center for over 10 years. The first, small (n = 74) prospective, single-blinded randomized study comparing MP and Cold Storage (CS) showed that the incidence of delayed graft function was higher after CS. There have been no reports in the literature on the effect of storage modality on long-term function of renal allografts. This paper presents an analysis of long-term results of renal transplantation in 415 patients operated on between 1994 and 1999. Of those, 227 kidneys were MP-stored prior to KTx. The control group consisted of 188 CS kidney transplants. Kidneys were not randomized to MP or to CS. Donor demographics, medical and biochemical data, cold ischemia time, HLA match and recipient data were collected. Standard triple-drug immunosuppression was administered to both groups. Mortality, graft survival and incidence of return to hemodialysis treatment were analyzed. Despite longer cold ischemia time and poorer donor hemodynamics in MP group, 5-year Kaplan-Meier graft survival was better in MP-stored than in CS-stored kidneys (68.2% vs. 54.2%, p = 0.02). In this nonrandomized analysis, kidney storage by MP improved graft survival and reduced the number of patients who returned to dialysis.
Solid pseudopapillary tumor (SPT) of the pancreas, also known as Franz tumor, Hamoudie tumor, solid-cystic-papillary epithelial neoplasm, or solid and cystic tumor, is a neoplasm of transitory (potential) malignancy, seen predominantly in young women. This report presents a female patient treated for a solid pseudopapillary tumor of the pancreas with hepatic metastases. The tumor was first diagnosed in 2006. Non-specific abdominal pain was the first presenting symptom. The patient underwent distal pancreatic resection and splenectomy in July 2006. Multifocal metastatic disease seen at surgery precluded radical resection. Following definitive pathology confirmation and the exclusion of extrahepatic metastases, the patient was referred to our transplant centre 18 months after pancreatic surgery, to be considered for orthotopic liver transplantation (OLTx). The extent of the disease was once again evaluated by imaging studies, followed by exploratory laparotomy. The patient underwent cadaveric liver transplantation in March 2008, with triple immunosuppression (tacrolimus, MMF, and steroids) following surgery. Presently, more than 5 years post-transplant, the patient has no signs of recurrent neoplasmatic disease. This is the first liver transplantation for a metastatic pancreatic pseudopapillary tumor in Poland, with the longest follow-up period described in the literature. Follow-up suggests a cautiously optimistic prognosis despite primary unresectability of hepatic metastases and the necessity for immunosuppressive therapy.