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Updated: Apr 6, 2026
Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function
Claus U Niemann1, John Feiner, Sharon Swain
1From the Department of Anesthesia and Perioperative Care (C.U.N., J.F.) and the Department of Surgery, Division of Transplant Surgery (C.U.N., R.H., J.P.R.), University of California, San Francisco, San Francisco, the California Transplant Donor Network, Oakland (S.S.), and OneLegacy, Los Angeles (S.B., M.F.) - all in California; the Section of Surgical Critical Care, Veterans Affairs Portland Health Care System (M.C., D.M.), and the Division of Trauma, Critical Care, and Acute Care Surgery, Oregon Health and Science University (D.M.) - both in Portland; and Berry Consultants, Austin, TX (K.B.).
Mild hypothermia in organ donors significantly reduces delayed graft function in kidney transplant recipients. This intervention improves long-term graft health and reduces healthcare costs associated with kidney transplantation.
Area of Science:
- Nephrology
- Transplantation immunology
- Organ preservation
Background:
- Delayed graft function (DGF) affects up to 50% of kidney transplant recipients, leading to increased costs and poorer long-term outcomes.
- The impact of pre-organ recovery mild hypothermia in donors on DGF rates remains unclear.
Purpose of the Study:
- To investigate the efficacy of targeted mild hypothermia in organ donors on reducing the incidence of delayed graft function in kidney transplant recipients.
Main Methods:
- Organ donors were randomized to either mild hypothermia (34-35°C) or normothermia (36.5-37.5°C) after declaration of death.
- Protocols were initiated post-authorization and concluded before organ recovery.
- The primary outcome was DGF, defined as the need for dialysis within the first week post-transplantation.
Main Results:
- The study was terminated early due to observed efficacy of hypothermia.
- Delayed graft function occurred in 28% of recipients from the hypothermia group versus 39% from the normothermia group (OR, 0.62; P=0.02).
- A total of 370 donors and 572 kidney recipients were included in the analysis.
Conclusions:
- Targeted mild hypothermia in deceased organ donors significantly decreases the rate of delayed graft function in kidney transplant recipients.
- This strategy represents a promising approach to improve early graft function and long-term transplant success.
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