PPART 2010

Methods	Study design: parallel RCT Duration of study: August 2006 to October 2007 Duration of follow‐up: 12 months
Participants	Country: UK Setting: multicentre Donor characteristics Mean age ± SD: 45.6 ± 29.2 years Number of DCD: 45 (90 kidneys) Number of ECD: 16 (32 kidneys) Sex (M/F): 29/16 Inclusion criteria: "All adult DCD donors at the five participating UK centers were eligible for the study although only controlled DCD donors, in whom further active treatment had been deemed futile and life‐supporting treatment withdrawn (Maastricht category 3), were entered." Exclusion criteria: not reported Recipient characteristics inclusion criteria: aged ≥ 18 years or over, and had a negative crossmatch. Exclusion criteria: previous nonrenal organ transplant Sex (M/F): MP group (31/14); SCS group (33/12) Mean age ± SD (years): MP group (50.3 ± 28.4); SCS group (48.6 ± 13.9)
Interventions	Machine perfusion LifePort transporter machines (Organ Recovery Systems) using KPS‐1 solution Static cold storage UW solution. Mean CIT Did not differ significantly between the groups: 14.3 hours in the SCS group and 13.9 hours in the MP group.
Outcomes	DGF PNF Creatinine Incidence of biopsy proven acute rejection Patient and graft survival Other measures of graft function
Notes	One kidney from each pair assigned to MP and the other to SCS A few of the kidneys only received MP at the recipient centre, but most also received it in transit. Relatively low rate of DGF overall, compared to DCDs in other studies, which could explain why this study was negative Funding source: " The Research described was funded by a large unrestricted research grant from Novartis Pharmaceuticals UK and a smaller grant from Organ Recovery Systems."
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer generated random sequences were used
Allocation concealment (selection bias)	Low risk	Central allocation at duty office of NHS blood and transplant
Blinding of participants and personnel (performance bias) All outcomes	Low risk	No blinding, but there was a randomisation scheme to dictate which kidney would be transplanted first, therefore the MP kidney was not always left to suffer longer CIT as is the case in some other studies
Blinding of outcome assessment (detection bias) All outcomes	Low risk	No blinding, but outcome measurements are unlikely to be affected by the lack of blinding
Incomplete outcome data (attrition bias) All outcomes	Low risk	Full follow‐up data for all patients, using an intention to treat model
Selective reporting (reporting bias)	Low risk	Outcomes suitable, with adequate reporting
Other bias	Low risk	All kidneys were transplanted, the indices gained from the MP process were not used to decide whether a kidney was transplanted