Assessment and Transplantation of Declined Human Kidneys Using Ex-Vivo Normothermic Kidney Perfusion.
1Department of Surgery, University of Cambridge, Cambridge, United Kingdom
2Transplantation, Transplant Institute, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: 330
Keywords: Donors, Kidney, Kidney transplantation, marginal, Preservation
Session Information
Session Name: Concurrent Session: Donors with Acute Kidney Injury
Session Type: Concurrent Session
Date: Monday, May 1, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 5:42pm-5:54pm
Location: E450a
Purpose
The aim of this study was to make more kidneys available for transplantation by using ex-vivo normothermic kidney perfusion (EVKP) technology to assess the quality of kidneys declined for transplantation and if suitable, transplant them.
Methods
Ethical approval was granted for this research study. After being declined for transplantation by all UK transplant centres and approval granted for research, kidneys were offered to the research team by the NHSBT duty office. Kidneys underwent 60 minutes of EVKP with an oxygenated plasma-free cell solution at 35.2 ± 0.2[deg]C. During EVKP the quality of each kidney was assessed using a scoring system based on macroscopic appearance during perfusion, renal blood flow and urine output.
Results
In a 12 month period, 74 kidneys from 51 donors were offered to the research study. Eight kidneys were accepted for EVKP assessment and 3 of these were successfully transplanted. Two of the recipients had initial graft function and 1 delayed graft function. The other 5 kidneys were not transplanted due to the following reasons; prolonged cold ischaemia due to delayed access to theatre (n =1), high Remuzzi biopsy score (n = 2), poor perfusion parameters during EVKP (n = 2).
Eighty nine percent of the kidneys offered were not recruited into the study due to a combination of adverse donor factors. Prolonged cold ischaemia at the time of offering was a significant factor in many of cases and the primary reason for non-recruitment in a third of the cases.
Conclusion
EVKP technology has unrealised potential to increase the number kidney transplants by assessing their quality prior to transplantation. Identifying these kidneys at an earlier stage to minimise the cold ischaemic time would allow more kidneys to be assessed and potentially transplanted.
CITATION INFORMATION: Hosgood S, Hamed M, Sawpaul A, Figueiredo R, Saeb-Parsy K, Wilson C, Nicholson M. Assessment and Transplantation of Declined Human Kidneys Using Ex-Vivo Normothermic Kidney Perfusion. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Hosgood S, Hamed M, Sawpaul A, Figueiredo R, Saeb-Parsy K, Wilson C, Nicholson M. Assessment and Transplantation of Declined Human Kidneys Using Ex-Vivo Normothermic Kidney Perfusion. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/assessment-and-transplantation-of-declined-human-kidneys-using-ex-vivo-normothermic-kidney-perfusion/. Accessed May 12, 2025.« Back to 2017 American Transplant Congress