HEMO₂ life® improves renal function independent of cold ischemia time in kidney recipients: A comparison with a large multicenter prospective cohort study

Background: M101 is an extracellular hemoglobin isolated from a marine lugworm and is present in the medical device HEMO₂ life®. The clinical investigation OXYOP was a paired kidney analysis (n = 60) designed to evaluate the safety and performance of HEMO₂ life® used as an additive to preservation solution in renal transplantation. The secondary efficacy endpoints showed less delayed graft function (DGF) and better renal function in the HEMO₂ life® group but due to the study design cold ischemia time (CIT) was longer in the contralateral kidneys.

Methods: An additional analysis was conducted including OXYOP patients and patients from the ASTRE database (n = 6584) to verify that the decrease in DGF rates observed in the HEMO₂ life® group may not be due solely to the shorter CIT but also to HEMO₂ life® performance. Kaplan-Meier estimate curves of cumulative probability of achieving a creatinine level below 250 µmol/L were generated and compared in both groups. A Cox model was used to test the effect of the explanatory variables (use of HEMO₂ life® and CIT). Finally, a bootstrap strategy was used to randomly select smaller samples of patients and test them for statistical comparison in the ASTRE database.

Results: Kaplan-Meier estimate curves confirmed the existence of a relation between DGF and CIT and Cox analysis showed a benefit in the HEMO₂ life® group regardless of the associated CIT. Boostrap analysis confirmed these results.

Conclusions: The present study suggested that the better recovery of renal function observed among kidneys preserved with HEMO₂ life® in the OXYOP study is a therapeutic benefit of this breakthrough innovative medical device.