At the ESOT 2011 meeting held in Glasgow, we were delighted to sponsor an educational symposium titled: Is there a role for machine perfusion in expanding ECD kidney programmes?
Professor Peter Friend, from the Oxford Transplant Centre, UK, chaired the meeting, opening by noting that transplants with ECD kidneys had increased 186% in the past 10 years across Europe. He remarked that DGF rates are high in ECD kidneys and that poor graft survival is exacerbated by DGF in such organs.
Dr Anja Gallinat, from the University of Essen, Germany, presented the 1-year data from the Machine Preservation Trial, with specific focus on the ECD data published in Transplant International in 2011. These data show that in recipients of grafts that developed DGF, machine preservation with the LifePort® Kidney Transporter significantly increased 1-year graft survival when compared to cold static storage (85% vs. 41%, p=0.003). Dr Gallinat concluded her session by outlining the importance of reducing DGF in improving the outcome in ECD kidneys.
Dr Stefan Tullius, from Harvard Medical School, Boston, USA, gave a stimulating presentation on the hypothesized mechanisms of action of machine perfusion, suggesting that the pulsatile flow provided by machine perfusion may protect the endothelium, thereby improving outcomes. He also presented evidence to show that the addition of pharmacological agents to the perfusate may contribute to the positive impact of machine perfusion on the outcome after kidney transplantation.
In a highly engaging presentation, Dr Robert Stratta, from Wake Forest Baptist Health, North Carolina, USA, gave his personal experience of transplanting ECD kidneys after machine perfusion over the past 10 years. He presented data from Wake Forest that showed a lower incidence of DGF in machine perfused ECD kidneys. In addition, the presence of DGF was associated with higher rates of kidney graft loss and mortality in donation after brain death, but not in donation after cardiac death donor kidney transplants at Wake Forest. He also reported that at his center, three times as many ECD kidneys are pumped compared with the national average in the USA.
In addition to the sponsored symposium, the LifePort® booth again proved popular as we previewed the LifePort 1.1 Kidney Transporter, available soon, and the LifePort Liver Transporter, the release of which is anticipated late 2012.
Feedback on the LifePort 1.1 Kidney Transporter was extremely positive, with Professor Ernest van Heurn of the Maastricht University Medical Center, the Netherlands stating: "Machine perfusion has proven to be superior to cold storage to preserve donor kidneys before transplantation. The possibility to oxygenate machine perfused kidneys, as in the new ORS machine, is the next step forwards."