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Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
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Machine perfusion in kidney transplantation
Ashish Kataria1, Sandeep Magoon2, Binni Makkar3
1Division of Nephrology, Department of Medicine, University at Buffalo, Buffalo, New York.
Current Opinion in Organ Transplantation
|June 18, 2019
Summary
Machine perfusion, including hypothermic (HMP) and normothermic (NMP) methods, offers a promising alternative to static cold storage for kidney transplantation. HMP reduces delayed graft function, while NMP may help utilize marginal kidneys.
Area of Science:
- Nephrology
- Transplantation Surgery
- Organ Preservation
Background:
- Kidney transplantation faces a significant shortage of donor organs, necessitating efficient utilization of available cadaveric kidneys.
- Machine perfusion techniques have gained prominence over traditional static cold storage (SCS) in recent years.
- Marginal kidneys, often discarded, present an opportunity for transplantation if preservation methods can mitigate risks.
Purpose of the Study:
- To review the role of machine perfusion in optimizing the use of cadaveric kidneys for transplantation.
- To evaluate the impact of machine perfusion on delayed graft function (DGF) and overall graft survival.
- To explore the potential of normothermic machine perfusion (NMP) in improving outcomes for marginal kidneys.
Main Methods:
- Review of current literature comparing hypothermic machine perfusion (HMP) and static cold storage (SCS).
- Analysis of studies investigating the efficacy of normothermic machine perfusion (NMP) for kidney preservation.
- Assessment of machine perfusion's capabilities for diagnostic and therapeutic interventions during organ preservation.
Main Results:
- Hypothermic machine perfusion (HMP) has demonstrated a reduction in delayed graft function (DGF) compared to static cold storage (SCS).
- HMP shows a trend towards improved overall graft survival, though long-term renal and patient outcomes require further investigation.
- Normothermic machine perfusion (NMP) shows potential in resuscitating discarded kidneys, with limited but promising pilot study data.
Conclusions:
- Machine perfusion, particularly HMP, is effective in reducing DGF and may improve graft survival in kidney transplantation.
- Further research is needed to clarify the long-term benefits of HMP and to establish the role of NMP in clinical practice.
- Machine perfusion offers a platform for interventions to assess and enhance kidney viability prior to transplantation.
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