A novel extracorporeal kidney perfusion system: a concept model

Area of Science:

• Transplantation immunology
• Organ preservation technology
• Nephrology

Background:

• Critical shortage of donor kidneys for transplantation.
• Increased use of marginal donor organs, including non-heart beating donors (NHBD).
• Need for reliable methods to assess donor kidney viability and compatibility before transplantation.

Purpose of the Study:

• To develop and evaluate an extracorporeal system for assessing donor kidney function and compatibility.
• To enable normothermic pulsatile perfusion of donor kidneys using potential recipient's blood.
• To monitor parameters indicative of graft viability and predict transplantation success.

Main Methods:

• Modification of a hypothermic pulsatile perfusion apparatus for normothermic perfusion.
• Extracorporeal perfusion of 10 porcine kidneys with autologous blood for at least two hours.
• Monitoring of perfusion pressure, flow rates, and urine production.
• Observation for signs of hyperacute rejection.

Main Results:

• A decrease in perfusion pressure with a concurrent increase in flow over two hours predicted graft viability and compatibility.
• The system allowed for normothermic pulsatile perfusion, monitoring of resistance to flow, and urine production.
• The model facilitated observation of hyperacute rejection in donor kidneys.

Conclusions:

• The developed system enables normothermic, pulsatile extracorporeal perfusion and assessment of donor kidneys.
• Key parameters like decreasing perfusion pressure and increasing flow can predict graft viability.
• Further research is needed to determine if this methodology can expand the donor organ pool.