Early Experience Of 48-hour Normothermic Machine Perfusion In Human Kidneys Applying Urine Recirculation
1Medical University of Innsbruck, Innsbruck, Austria, 2Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
Meeting: 2022 American Transplant Congress
Abstract number: 9050
Keywords: Kidney, Machine preservation, Perfusion, Renal function
Topic: Basic Science » Basic Science » 15 - Machine Perfusion and Organ Rehabililtation - Basic
Session Information
Session Name: Machine Perfusion and Organ Rehabilitation - Basic
Session Type: Poster Abstract
Date: Sunday, June 5, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Normothermic machine perfusion (NMP) of the kidney has been studied extensively during the past decade. Short-term kidney NMP has demonstrated promising results, however currently transplant logistics cannot be improved and for organ treatment longer preservation periods might be necessary. As a proof of principle, we aimed to achieve 48-hour NMP by applying urine recirculation (UR) with a commercially available perfusion device.
*Methods: Discarded human kidneys were normothermically perfused on the XVIVO Kidney Assist perfusion device. The perfusate comprised packed red cells and 5% albumin. For volume management UR was applied. Air (21% O2) and CO2 were used for oxygenation of the circuit and monitored with an in-line blood gas analyzer. Perfusate and urine samples as well as hemodynamics were regularly assessed.
*Results: Five discarded human kidneys underwent kidney NMP following hypothermic machine perfusion (HMP) and static cold storage. All but one kidneys were DBD organs. Median donor age (range) was 62 (41-68) years. Median (IQR) CIT and HMP were 19.9 (12.1) h and 5 (7.2) h. An NMP duration of 48 h could be achieved in all kidneys. All kidneys were urinating throughout with a median (IQR) output of 22.5 (30.5) ml/h. Overall median (IQR) arterial flow was 695 (383) ml/min. Median (IQR) pH was 7.2 (0.2). Overall median (IQR) perfusate sodium, chloride and potassium were 161 (14.7) mmol/L, 124.5 (11.5) mmol/L, and 6.5 (2.7) mmol/L. Median (IQR) perfusate lactate over time was 109 (55.2) mg/dL. Median perfusate sodium and chloride were significantly higher than corresponding urine values (sodium: 130 (27) mmol/L, chloride: 120.5 (11.8) mmol/L) over time (P = 0.02 and 0.04). Median arterial flow over time was significantly higher in NMP kidneys with lower perfusate sodium levels (p<0.001, correlations coefficient Spearman’s rho -0.461).
*Conclusions: This early experience underlines the feasibility of extended ex-situ kidney NMP by applying UR. Hemodynamic stability and urine excretion were achieved for 48 hours.
To cite this abstract in AMA style:
Messner F, Gasteiger S, Pühringer-Sturmayr M, Soleiman A, Öfner D, Schneeberger S, Weissenbacher A. Early Experience Of 48-hour Normothermic Machine Perfusion In Human Kidneys Applying Urine Recirculation [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/early-experience-of-48-hour-normothermic-machine-perfusion-in-human-kidneys-applying-urine-recirculation/. Accessed May 16, 2025.« Back to 2022 American Transplant Congress