Twelve Hour Ex Vivo Normothermic Perfusion for the Assessment of High-Risk Discarded Deceased Donor Kidneys.
Department of Surgery, UC Davis Medical Center, Sacramento, CA
Meeting: 2017 American Transplant Congress
Abstract number: A154
Keywords: High-risk, Ischemia, Kidney, Perfusion solutions
Session Information
Session Name: Poster Session A: Ischemic Injury and Organ Preservation Session I
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Ex-Vivo Normothermic Perfusion (EVNP) has been shown to be useful to assess viability of high-risk deceased donor kidneys, with high renal blood flow and immediate diuresis being proposed as criteria for deeming an organ as transplantable. Little is known about the safety and efficacy of longer periods EVNP to assess high-risk kidneys.
Eight single high-risk deceased human kidneys initially procured for transplantation but discarded were placed on 12 hours of EVNP pressure dependent cardiopulmonary bypass system at 37[deg] C with leukocyte depleted packed red blood cells (PRBC), supplemented with nutrition and insulin. Exogenous creatinine (0.06 g) was added to the system to assess glomerular filtration. Pump parameters were monitored every 30 min. Blood samples and urine samples were collected every 30 min and analyzed for pH, oxygen, electrolytes, creatinine, and lactate.
Flow and urine output (UO) were continuously assessed throughout perfusion. At 8 hours, 5 kidneys were optimally perfusing with high increasing renal blood flow (>100 cc/hr) and UO (>15 cc/hr). 2 kidneys were marginally perfusing with high increasing renal blood flow (>100 cc/hr) and UO (<15 cc/hr). 1 kidney had high renal blood flow but no UO. Perfusion characteristics are shown below.
| Optimally Perfused
(n=5) |
Marginally Perfused
(n=2) |
Unpaired T-Test | |
| Age | 42.8+15.1 | 54.5+14.9 | 0.40 |
| KDPI | 65+17.7 | 73+32.5 | 0.68 |
| Terminal Creatinine | 1.62+1.0 | 3.15+2.1 | 0.21 |
| Cold Ischemia Time | 29.11+5.6 | 47.5+11.8 | 0.03* |
| Flow at 8 hrs | 380+229.8 | 335+7.1 | 0.80 |
| UO at 8 hrs | 52.6+27.0 | 6.3+1.1 | 0.07 |
| Blood Creatinine at 8 hrs | 1.1+0.8 | 1.7+0.9 | 0.42 |
| Blood Lactate at 8 hrs | 13.1+4.3 | 19.8+0.4 | 0.09 |
Prolonged duration of EVNP for 12 hours is safe and feasible to assess function of high-risk kidneys. Longer periods of EVNP may be necessary to properly assess function.
CITATION INFORMATION: Palma I, Palma I, Smolin Y, Kabagambe S, Perry A, Sageshima J, Perez R. Twelve Hour Ex Vivo Normothermic Perfusion for the Assessment of High-Risk Discarded Deceased Donor Kidneys. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Palma I, Palma I, Smolin Y, Kabagambe S, Perry A, Sageshima J, Perez R. Twelve Hour Ex Vivo Normothermic Perfusion for the Assessment of High-Risk Discarded Deceased Donor Kidneys. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/twelve-hour-ex-vivo-normothermic-perfusion-for-the-assessment-of-high-risk-discarded-deceased-donor-kidneys/. Accessed November 21, 2024.« Back to 2017 American Transplant Congress