Related Experiment Video
Updated: Mar 1, 2026
Normothermic Machine Perfusion of Rat Kidneys for Transplantation
Published on: January 27, 2026
Mesenchymal Stromal Cells as Anti-Inflammatory and Regenerative Mediators for Donor Kidneys During Normothermic
Jesus Maria Sierra-Parraga1, Marco Eijken2, James Hunter3
11 Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC, University Medical Center , Rotterdam, the Netherlands .
Abstract:
There is great demand for transplant kidneys for the treatment of end-stage kidney disease patients. To expand the donor pool, organs from older and comorbid brain death donors, so-called expanded criteria donors (ECD), as well as donation after circulatory death donors, are considered for transplantation. However, the quality of these organs may be inferior to standard donor organs. A major issue affecting graft function and survival is ischemia/reperfusion injury, which particularly affects kidneys from deceased donors. The development of hypothermic machine perfusion has been introduced in kidney transplantation as a preservation technique and has improved outcomes in ECD and marginal organs compared to static cold storage. Normothermic machine perfusion (NMP) is the most recent evolution of perfusion technology and allows assessment of the donor organ before transplantation. The possibility to control the content of the perfusion fluid offers opportunities for damage control and reparative therapies during machine perfusion. Mesenchymal stromal cells (MSC) have been demonstrated to possess potent regenerative properties via the release of paracrine effectors. The combination of NMP and MSC administration at the same time is a promising procedure in the field of transplantation. Therefore, the MePEP consortium has been created to study this novel modality of treatment in preparation for human trials. MePEP aims to assess the therapeutic effects of MSC administered ex vivo by NMP in the mechanisms of injury and repair in a porcine kidney autotransplantation model.
Insights
Normothermic machine perfusion (NMP) combined with mesenchymal stromal cells (MSC) shows promise for improving kidney transplant outcomes. This approach aims to reduce injury and enhance repair in donor kidneys, expanding the potential for life-saving transplants.
Area of Science:
- Transplantation immunology
- Regenerative medicine
- Organ preservation
Background:
- Increasing demand for kidney transplants necessitates utilizing organs from expanded criteria donors (ECD) and donation after circulatory death (DCD).
- Ischemia/reperfusion injury significantly impacts graft survival, especially in deceased donor kidneys.
- Hypothermic machine perfusion (HMP) has improved outcomes for marginal organs compared to static cold storage.
Purpose of the Study:
- To evaluate the therapeutic potential of combining normothermic machine perfusion (NMP) with mesenchymal stromal cells (MSC) for kidney preservation.
- To investigate the mechanisms of injury and repair in donor kidneys treated with NMP and MSC ex vivo.
- To lay the groundwork for future human clinical trials of this novel transplantation strategy.
Main Methods:
- Utilizing a porcine kidney autotransplantation model.
- Administering mesenchymal stromal cells (MSC) during normothermic machine perfusion (NMP).
- Assessing the effects of NMP-MSC treatment on kidney injury and repair mechanisms.
Main Results:
- The study is designed to assess therapeutic effects and mechanisms, with results pending further investigation.
- Preliminary data suggests NMP allows for organ assessment and potential therapeutic interventions.
- MSC demonstrate regenerative properties through paracrine effectors.
Conclusions:
- The combination of NMP and MSC represents a promising strategy to mitigate ischemia/reperfusion injury and enhance kidney graft quality.
- This approach could expand the donor pool and improve outcomes for patients awaiting kidney transplantation.
- The MePEP consortium's research is crucial for advancing ex vivo organ perfusion therapies towards clinical application.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:19Mesenchymal Stem Cells