Development of an Automatic Regulated Normothermic Kidney Preservation Device for Long-Term Organ Perfusion.
1Nuffield Department of Surgical Sciences, Oxford Transplant Centre, University of Oxford, Oxford, United Kingdom
2Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
3OrganOx Limited, Magdalen Centre, Oxford Science Park, Oxford, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: A259
Keywords: Donors, Kidney, Machine preservation, marginal, Preservation
Session Information
Session Name: Poster Session A: Organ Preservation and Reperfusion
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Background
Normothermic kidney perfusion for a period of 24 hours or longer would offer significant clinical advantages. It would enable clinicians to investigate the condition of renal parenchyma during the warm preservation period and provide a platform for repairing/reconditioning kidneys that are currently discarded. This would enlarge the donor pool and enable more successful renal transplants.
Methods
We have established an automatically-regulated closed-circuit normothermic kidney perfusion prototype, with the objective of perfusing human kidneys for 24 hours. The kidney device is based on the liver perfusion method previously developed by our team together with Organox®Limited. We have used human kidneys declined by all transplant centers to develop and test the perfusion device.
Results
19 discarded human kidneys from DBD (donation after brain death) and DCD (donation after cardiac death) donors have been perfused, providing evidence of stable and physiological functional parameters. Cold ischemia time (CIT) was significantly longer in DCD kidneys compared to DBD kidneys; p=0.033. Measured biochemical parameters, included glucose, lactate and anti-Xa levels. All but one perfused kidneys showed clear evidence of glucose consumption. Previously validated biomarkers were tested: in the shorter CIT group (<1518 min), NGAL showed a significant change between hours 1 and 24; p=0.0144. KIM-1 was different in the short CIT group at time points 12 and 24 hours compared to hour 1; p=0.047 and 0.0077. In the group of kidneys which produced less than 460ml of urine, the NGAL expression was significantly higher over time; p=0.0178. Similarly for KIM-1: in the group <460ml of urine, KIM-1 expression was significantly higher over time; p=0.0010. There was no difference in L-FABP expression.
Conclusion
Automated normothermic kidney perfusion for at least 24 hours was shown to be feasible, with the ability to measure biomarkers that might reliably indicate viability in otherwise marginal donor organs. Clinical studies are now needed to demonstrate the clinical utility of this technology.
CITATION INFORMATION: Weissenbacher A, Boubriak O, Lo Faro L, Ploeg R, Hunter J, Voyce D, Mikov N, Cook A, Coussios C, Friend P. Development of an Automatic Regulated Normothermic Kidney Preservation Device for Long-Term Organ Perfusion. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Weissenbacher A, Boubriak O, Faro LLo, Ploeg R, Hunter J, Voyce D, Mikov N, Cook A, Coussios C, Friend P. Development of an Automatic Regulated Normothermic Kidney Preservation Device for Long-Term Organ Perfusion. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/development-of-an-automatic-regulated-normothermic-kidney-preservation-device-for-long-term-organ-perfusion/. Accessed May 12, 2025.« Back to 2017 American Transplant Congress