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Brief Normothermic Machine Perfusion Rejuvenates Discarded Human Kidneys
Ahmer M Hameed1,2,3, David B Lu2,4, Ellis Patrick2
1Department of Surgery, Westmead Hospital, Sydney, NSW, Australia.
Transplantation Direct
|November 28, 2019
Summary
Normothermic machine perfusion (NMP) improved discarded kidneys, showing better function and reduced cell death compared to cold static storage (CS). NMP may decrease organ discards and enhance early transplant graft function.
Area of Science:
- Transplantation immunology
- Organ preservation
- Renal physiology
Background:
- Normothermic machine perfusion (NMP) offers potential for kidney resuscitation and assessment before transplantation.
- Cold static storage (CS) is the standard method, but may not optimize marginal organs.
Purpose of the Study:
- To investigate the mechanistic basis and translational potential of NMP versus CS for discarded human kidneys.
- To compare NMP and CS in a simulated transplantation model.
Main Methods:
- Discarded human kidneys (n=15) underwent 1-hour NMP after CS.
- Paired kidneys were compared using simulated transplantation with allogeneic whole blood.
- Parameters assessed included renal perfusion, biochemistry, histology, and RNA sequencing.
Main Results:
- NMP successfully perfused kidneys, improving blood flow and showing urine output.
- NMP resolved nonperfused areas in donation after circulatory death kidneys.
- NMP demonstrated improved renal perfusion, better functional parameters, and reduced cell death, oxidative stress, and complement activation compared to CS.
Conclusions:
- NMP showed significant mechanistic benefits over CS for discarded marginal kidneys in a preclinical simulated transplant model.
- NMP holds potential to reduce organ discard rates and improve early graft function.
