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Updated: May 10, 2026
Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
[Non-heart-beating kidney donors: first improve ischemic times, then allocation]
1Academisch Medisch Centrum, afd. Nefrologie, Amsterdam, the Netherlands. j.j.homanvanderheide@amc.uva.nl
Insights
Kidney graft survival is impacted by donor age and type. Non-heart-beating donor kidneys require reduced cold ischemic times for better outcomes.
Area of Science:
- Nephrology
- Transplantation
- Public Health
Background:
- Kidney transplantation is a vital treatment for end-stage renal disease.
- The use of non-heart-beating (NHB) donors is increasing globally, including in the Netherlands.
- Optimizing graft survival from NHB donors is crucial for efficient organ allocation.
Purpose of the Study:
- To investigate the 3-year graft survival rates of kidney donations from heart-beating (HB) and NHB donors.
- To analyze the impact of donor age on kidney graft survival.
- To evaluate the tolerance of NHB kidneys to cold ischemia compared to HB kidneys.
Main Methods:
- Analysis of a UK registry dataset.
- Comparison of graft survival between HB and NHB donor groups.
- Assessment of cold ischemic time impact on graft outcomes.
Main Results:
- Donor age significantly affects kidney graft survival.
- NHB donor kidneys exhibit reduced tolerance to cold ischemia compared to HB donor kidneys.
- Current ischemic times present challenges, particularly for NHB donor kidneys.
Conclusions:
- Kidney graft survival is influenced by donor age and type.
- Strategies to minimize cold ischemic time for NHB donor kidneys are necessary.
- Revising organ allocation algorithms and addressing ischemic times are recommended for the Dutch context.
Abstract:
A study recently published in The Lancet investigated the 3-year graft survival of heart-beating (HB) and non-heart-beating (NHB) kidney donors. This was done utilizing the UK registry. The study concluded that donor age affects graft survival. It also demonstrated that NHB kidneys tolerate cold ischemia less well than kidneys from HB donors. Based on these conclusions, it is suggested that a different allocation algorithm should be designed in order to reduce ischemic time for NHB donor kidneys. These findings are relevant to the Dutch situation in which more than 50% of postmortal kidney donors are now NHB. Despite past efforts, ischemic times in the Netherlands can still be improved compared to neighbouring countries. It is proposed that this matter be dealt with prior to changes in the allocation algorithm.
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