Successful 96- and 144-hour experimental kidney preservation: A combination of standard machine preservation and newly developed normothermic ex vivo perfusion

Wijk, Jeroen van; Slooff, Maarten J. H.; Rijkmans, B.G.; Kootstra, G.

doi:10.1016/0011-2240(80)90057-7

Cited by 32 publications

(6 citation statements)

References 7 publications

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“…First experiments investigating normothermic preservation techniques using heparinized whole blood were conducted in canine models already in the late 1970s and the early 1980s by Kootstra. 55,56 Aiming for prolongation of preservation times, a combination of HMP (8°C) and normothermic ex vivo perfusion (38°C) was performed for up to 144 hours in heart-beating donation kidneys. After renal autotransplantation, grafts that underwent a phase of 3 or 4 hours of normothermic ex vivo perfusion during the preservation period demonstrated significantly lower serum creatinine values and improved animal survival when compared with continuously hypothermic perfused grafts.…”

Section: Discussionmentioning

confidence: 99%

Continuous Normothermic Ex Vivo Kidney Perfusion Improves Graft Function in Donation After Circulatory Death Pig Kidney Transplantation

Kaths

Echeverri²,

Chun³

et al. 2017

Transplantation

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Section: Discussionmentioning

confidence: 99%

Continuous Normothermic Ex Vivo Kidney Perfusion Improves Graft Function in Donation After Circulatory Death Pig Kidney Transplantation

Kaths

Echeverri²,

Chun³

et al. 2017

Transplantation

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“…Nonetheless, EVNP may also be beneficial if carried out at an earlier stage. Evidence from several historical, experimental studies suggests that a short period of EVNP in the middle of the preservation interval may protect the kidney against additional cold ischemic (CI) injury . Herein, we report a case of intermediate EVNP in clinical kidney transplantation.…”

Section: Introductionmentioning

confidence: 91%

The First Clinical Case of Intermediate Ex Vivo Normothermic Perfusion in Renal Transplantation

Hosgood

Nicholson

2014

American Journal of Transplantation

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A short period of ex vivo normothermic perfusion (EVNP) immediately before transplantation can revive the kidney and reduce the effects of cold ischemic (CI) injury. Herein, we report a clinical case of EVNP carried out at an intermediate period of the preservation interval. The kidney was retrieved from a 63-year-old extended criteria donor. After 10 h 29 min of CI the kidney underwent EVNP with 1 unit of compatible packed red blood cells mixed with a priming solution at 35.08C while the recipient was being prepared for surgery. The mean renal blood flow was 93.6 mL/min/ 100 g and the kidney produced 60 mL of urine. Shortly after the start of surgery the first intended recipient became unfit for transplantation. After 60 min EVNP the kidney was flushed with cold preservation solution and re-packed in ice. The second period of CI was 5 h and 21 min. The kidney was transplanted without any complications into a 54-year-old predialysis patient. The recipient had immediate graft function with serum creatinine levels falling from 315 to 105 mmol/L by day 7. This is the first report of an intermediate period of EVNP in clinical renal transplantation. This case demonstrates the feasibility and safety of the technique.

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“…Normothermic machine perfusion (NMP) offers a distinct approach to organ preservation by mimicking a near-physiological environment [38]. It supports normal cellular metabolism, repair processes, and ATP production by using a modified extracorporeal membrane oxygenation (ECMO) machine to perfuse the kidney with an oxygenated plasma-free red blood cell-based solution [39,40].…”

Section: Oxygenated Normothermic Machine Perfusionmentioning

confidence: 99%

Organ storage in renal transplantation

Guo,

Luke,

Sener

2023

Current Opinion in Urology

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Purpose of review Kidney transplantation is vital for those with end-stage renal disease, enhancing quality of life and longevity. It is the preferred treatment but is hindered by a global disparity between donor kidney availability and demand. Therefore, optimizing organ storage techniques is crucial to mitigate the effects of ischemia reperfusion injury in available organs. Recent interest has centered on innovative methods like oxygenated normothermic perfusion and abdominal regional perfusion. Recent findings Multiple recent metanalyses, including a Cochrane review, confirm the benefits of hypothermic machine perfusion (HMP) for deceased donor kidneys, demonstrating its utility and cost effectiveness. The benefits of oxygenated normothermic perfusion have been seen in retrospective data sets but not in prospective trials. Abdominal regional perfusion (aNRP) is gaining interest, especially for liver transplantation, but kidney specific data are scant. Summary High-quality evidence backs the use of HMP for deceased donor kidneys. Despite interest in other techniques, clinical evidence for their benefits in kidney transplantation is lacking. The gap between innovation and verified success emphasizes the need for continued research and collaboration between medical professionals, researchers, and ethical committees. This review aims to further illuminate the complexities and advancements in the field, bridging the knowledge gap and aiding in the continual pursuit of excellence in transplantation.

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Successful 96- and 144-hour experimental kidney preservation: A combination of standard machine preservation and newly developed normothermic ex vivo perfusion

Cited by 32 publications

References 7 publications

Continuous Normothermic Ex Vivo Kidney Perfusion Improves Graft Function in Donation After Circulatory Death Pig Kidney Transplantation

Continuous Normothermic Ex Vivo Kidney Perfusion Improves Graft Function in Donation After Circulatory Death Pig Kidney Transplantation

The First Clinical Case of Intermediate Ex Vivo Normothermic Perfusion in Renal Transplantation

Organ storage in renal transplantation

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