Evidence-Based Recommendations for the Use of Machine Perfusion in Kidney Transplantation

Machine perfusion has become a transformative approach in deceased donor organ transplantation, providing notable enhancements in graft survival, decreases in rates of delayed graft function, and increased use of marginal extended criteria kidneys. Here, we have presented recommendations compiled from findings in recent international and national research and presented a framework specific to India designed for both public and private sector transplant initiatives. We have delineated optimal practices for selecting patients, presented various perfusion techniques (hypothermic and normothermic), assessed viability, components of the perfusate, and delineated financial considerations and strategies for implementation.