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Successful Transplantation of Human Kidneys Deemed Untransplantable but Resuscitated by Ex Vivo Normothermic Machine Perfusion

Published version
Peer-reviewed

Type

Article

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Authors

Hosgood, SA 
Saeb-Parsy, Kourosh  ORCID logo  https://orcid.org/0000-0002-0633-3696
Hamed, MO 
Nicholson, ML 

Abstract

We report the successful transplantation of a pair of human kidneys that were declined for transplantation due to inadequate in situ perfusion but subsequently transplanted after perfusion and assessment using ex vivo normothermic perfusion (EVNP). The kidneys were from a 35-year-old man, a donation after circulatory death donor. Both kidneys were declined by all UK transplant centers. On arrival, the kidneys had significant areas of incomplete clearance of blood from the microcirculation that did not clear after a further attempt to flush them. Kidneys underwent 60 min of EVNP with an oxygenated packed red blood cell–based solution warmed to 35.2°C. During EVNP, the patchy areas cleared in both kidneys. The mean renal blood flow and total urine output were 68.0 mL/min/100 g and 560 mL in the left kidney and 59.9 mL/min/100 g, 430 mL in the right, respectively. Based on the EVNP perfusion parameters, both kidneys were deemed suitable for transplantation. They were transplanted without any complications, and both recipients had initial graft function. The serum creatinine levels at 3 months were 1.2 mg/dl in the recipient of the left kidney and 1.62 mg/dl in the recipient of the right kidney. EVNP technology can be used to assess and rescue kidneys previously deemed unsuitable for transplantation.

Description

Keywords

clinical research/practice, kidney transplantation/nephrology, organ acceptance, organ perfusion and preservation, Adult, Aged, Female, Graft Rejection, Humans, Kidney Function Tests, Kidney Transplantation, Liver, Male, Organ Preservation, Outcome Assessment, Health Care, Perfusion, Tissue Donors, Tissue Survival, Tissue and Organ Procurement

Journal Title

American Journal of Transplantation

Conference Name

Journal ISSN

1600-6135
1600-6143

Volume Title

16

Publisher

Wiley-Blackwell
Sponsorship
This study was supported by Kidney Research UK. The research was also funded by the National Institute for Health Research Blood and Transplant Research Unit (NIHR BTRU) in Organ Donation and Transplantation at the University of Cambridge in collaboration with Newcastle University and in partnership with NHS Blood and Transplant (NHSBT). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health, or NHSBT.