Normothermic ex vivo kidney perfusion for the preservation of kidney grafts prior to transplantation

J. Moritz Kaths, Vinzent N. Spetzler, Nicolas Goldaracena, Juan Echeverri, Kristine S. Louis, Daniel B. Foltys, Mari Strempel, Paul Yip, Rohan John, Istvan Mucsi, Anand Ghanekar, Darius Bagli, Lisa Robinson, Markus Selzner

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18 Citations (Scopus)

Abstract

Kidney transplantation has become a well-established treatment option for patients with end-stage renal failure. The persisting organ shortage remains a serious problem. Therefore, the acceptance criteria for organ donors have been extended leading to the usage of marginal kidney grafts. These marginal organs tolerate cold storage poorly resulting in increased preservation injury and higher rates of delayed graft function. To overcome the limitations of cold storage, extensive research is focused on alternative normothermic preservation methods. Ex vivo normothermic organ perfusion is an innovative preservation technique. The first experimental and clinical trials for ex vivo lung, liver, and kidney perfusions demonstrated favorable outcomes. In addition to the reduction of cold ischemic injury, the method of normothermic kidney storage offers the opportunity for organ assessment and repair. This manuscript provides information about kidney retrieval, organ preservation techniques, and isolated ex vivo normothermic kidney perfusion (NEVKP) in a porcine model. Surgical techniques, set up for the perfusion solution and the circuit, potential assessment options, and representative results are demonstrated.

Original languageEnglish
Article numbere52909
Pages (from-to)1-13
Number of pages13
JournalJournal of Visualized Experiments
Volume2015
Issue number101
DOIs
Publication statusPublished - Jul 15 2015

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Keywords

  • Cold storage (CS)
  • Delayed graft function (DGF)
  • Donation after circulatory death (DCD)
  • Extended criteria donor (ECD)
  • Hypothermic machine perfusion (HMP)
  • Kidney transplantation
  • Marginal graft
  • Medicine
  • Normothermic ex vivo kidney perfusion (NEVKP)
  • Organ preservation
  • Organ shortage
  • Primary non function (PNF)
  • Standard criteria donor (SCD)

ASJC Scopus subject areas

  • Neuroscience(all)
  • Chemical Engineering(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

Cite this

Kaths, J. M., Spetzler, V. N., Goldaracena, N., Echeverri, J., Louis, K. S., Foltys, D. B., Strempel, M., Yip, P., John, R., Mucsi, I., Ghanekar, A., Bagli, D., Robinson, L., & Selzner, M. (2015). Normothermic ex vivo kidney perfusion for the preservation of kidney grafts prior to transplantation. Journal of Visualized Experiments, 2015(101), 1-13. [e52909]. https://doi.org/10.3791/52909