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Normothermic kidney preservation

Hosgood, Sarah A; Nicholson, Michael L

Current Opinion in Organ Transplantation: April 2011 - Volume 16 - Issue 2 - p 169–173
doi: 10.1097/MOT.0b013e3283446a5d
Organ preservation and procurement: Edited by Ernest van Heurn
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Purpose of review Kidneys from marginal or donation after cardiac death (DCD) donors are particularly susceptible to injury during hypothermic preservation and may benefit from alternative methods of preservation. Normothermic preservation can be adapted to improve the quality of kidneys for transplantation by a variety of techniques.

Recent findings Extracorporeal membrane support to maintain circulation before cooling and organ retrieval has been used to improve the condition of DCD donor kidneys, with lower rates of delayed graft function (DGF) compared with standard retrieval conditions. Experimentally, normothermic perfusion has been used in conjunction with hypothermic techniques as a resuscitation technique to improve graft outcome. An ex-vivo porcine kidney model showed that energy levels could be replenished to improve tissue perfusion during reperfusion. This technique was translated into a porcine transplant model demonstrating that it was a feasible and safe method of preservation.

Summary Normothermic preservation techniques have the potential to be adapted into an improved method of retaining tissue viability compared with hypothermic techniques. Furthermore, they may be used as a device to enhance and assess the condition of the kidney which would be particularly beneficial for kidneys from DCD donors.

Department of Infection, Immunity and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester, UK

Correspondence to Professor Michael L Nicholson, MD, DSc, FRCS, Transplant Group, University Hospitals of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK Tel: +44 116 2584604; fax: +44 116 2490064; e-mail: mln2@le.ac.uk

© 2011 Lippincott Williams & Wilkins, Inc.