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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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Developing an Injury-Free 15 Hour Preservation Protocol of Donor Porcine Kidneys Using Normothermic Machine Perfusion
John P Stone1,2, William R Cowey1,2, Corban J T Bowers1,2
1From The Pebble Institute, Beech Court, Wilmslow, United Kingdom.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|May 20, 2024
Summary
Normothermic machine perfusion (NMP) safely preserves kidneys for over 15 hours, demonstrating improved hemodynamics and sustained function. This advancement supports kidney transplantation by maintaining organ health and reducing hypothermic injury.
Area of Science:
- Organ transplantation research
- Renal preservation techniques
- Machine perfusion technologies
Background:
- Normothermic machine perfusion (NMP) is superior to hypothermic preservation but limited in duration.
- Extending NMP time could allow for transplantation scheduling and functional assessment.
- Current preservation methods carry risks of hypothermic injury.
Purpose of the Study:
- To evaluate the safety and efficacy of an extended NMP protocol for porcine kidney preservation.
- To assess kidney function and viability after prolonged NMP.
- To determine if extended NMP can maintain kidneys in a transplantable state.
Main Methods:
- Porcine kidneys were preserved using NMP for 12 hours after initial hypothermic storage.
- Hemodynamics, biochemistry, urine output, and histological assessments were performed.
- Kidney viability was evaluated using a clinical perfusion assessment score.
Main Results:
- Kidneys exhibited continuous hemodynamic improvement and sustained urine production.
- Biochemical analysis indicated active renal metabolic processes (gluconeogenesis, Cori cycle).
- All kidneys scored as transplantable with no histological evidence of injury.
Conclusions:
- The developed NMP protocol safely preserves kidneys for over 15 hours.
- Extended NMP maintains stable hemodynamics, biochemistry, and renal function.
- This technique offers a promising approach to reduce hypothermic injury and enable elective kidney transplantation.
