J Malaise, et al. Université de Montréal, Québec, Canada
While HMP has been widely studied in deceased donor kidneys, a group from Université de Montréal, Canada, investigated hypothermic machine perfusion (HMP) as a means for reducing the occurrence of potential adverse effects during travel in paired kidney exchange programs. A total of 24 kidneys from living donors were perfused using the LifePort Kidney Transporter, with 7 kidneys traveling to a pediatric transplantation center.
Results showed no delayed graft function or primary non-function occurred, and there was no graft loss or patient death. In several transplants, very high renovascular resistances were noted, which is unexpected in living donation. Mean renal resistance at the start of machine perfusion was 1.03mmHg/ml/min (range 0.34–3.12) which reduced to 0.31mmHg/ml/min (range 0.10–0.49) at the end. No pre- or intraoperative conditions could explain this phenomenon.
The authors surmised that the high level of renovascular resistance was probably a result of the impact of warm ischemia on the graft. In reducing renal resistance, HMP may help prevent the deleterious effect on the kidney.