Renal Transplantation After Ex Vivo Normothermic Perfusion: The First Clinical Study

Am J Transplant. 2013 May;13(5):1246-52. doi: 10.1111/ajt.12179. Epub 2013 Feb 22.

Abstract

Ex vivo normothermic perfusion (EVNP) is a novel method of preservation that restores circulation and allows an organ to regain function prior to transplantation. The aim of this study was to assess the effects of EVNP in kidneys from marginal donors. Eighteen kidneys from extended criteria donors (ECD) underwent a period of EVNP immediately before transplantation. Kidneys were perfused with a plasma free red-cell based solution at a mean temperature of 34.6°C. The outcome of these kidneys was compared to a control group of 47 ECD kidneys that underwent static cold storage (CS). The mean donor age was 61 ± 1 years in the EVNP and 62 ± 6 years in the CS group (p = 0.520). EVNP kidneys were perfused for an average of 63 ± 16 min and all were transplanted successfully. The delayed graft function rate (DGF), defined as the requirement for dialysis within the first 7 days was 1/18 patients (5.6%) in the EVNP group versus 17/47 (36.2%) in the CS group (p = 0.014). There was no difference in graft or patient survival at 12 months (p = 0.510, 1.000). This first series of EVNP in renal transplantation demonstrates that this technique is both feasible and safe. Our preliminary data suggests that EVNP offers promise as a new technique of kidney preservation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delayed Graft Function / mortality
  • Delayed Graft Function / physiopathology*
  • Extracorporeal Circulation
  • Female
  • Follow-Up Studies
  • Graft Survival / physiology*
  • Humans
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Organ Preservation / methods*
  • Perfusion / methods*
  • Prospective Studies
  • Regional Blood Flow
  • Renal Circulation / physiology*
  • Survival Rate / trends
  • Treatment Outcome
  • United Kingdom / epidemiology