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Ex Situ Normothermic Machine Perfusion of Donor Livers
Published on: May 26, 2015
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Hypothermic machine perfusion permits extended cold ischemia times with improved early graft function
Alison Guy1, Damian McGrogan, Nicholas Inston
1From the Department of Renal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Summary
Hypothermic machine perfusion allows for extended cold ischemia time in deceased-donor kidney transplants, leading to improved early graft function compared to static cold storage. This technique enhances transplant logistics and outcomes.
Area of Science:
- Nephrology
- Transplant Surgery
- Organ Preservation
Background:
- Cold ischemia time significantly impacts deceased-donor renal transplant outcomes.
- Extending cold ischemia time is desirable to accommodate logistical and clinical factors.
- Current static cold storage methods have limitations in managing prolonged ischemia.
Purpose of the Study:
- To investigate the efficacy of hypothermic machine perfusion (HMP) in extending cold ischemia time for deceased-donor kidneys.
- To compare early graft outcomes between HMP and static cold storage (SCS).
Main Methods:
- Deceased-donor kidneys were assigned to either SCS or HMP based on predicted transplant timing.
- Kidneys with predicted out-of-hours operations were placed on HMP.
- Standard SCS was used for kidneys with predicted in-hours operations.
Main Results:
- Median cold ischemia time was significantly longer in the HMP group (23.85 hours) versus the SCS group (13 hours).
- Delayed graft function occurred in 27% of HMP kidneys compared to 47% of SCS kidneys (P = .012).
- No significant differences were observed in other graft or postoperative complications.
Conclusions:
- Hypothermic machine perfusion enables longer cold ischemia times with improved early graft outcomes in renal transplantation.
- HMP may offer multifactorial benefits including organ preservation and optimized perioperative conditions.
- This suggests HMP is a valuable alternative to SCS for managing deceased-donor kidneys.
