A study at the Queen Elizabeth Hospital in Birmingham, UK, presented at the recent American Transplant Congress (ATC) demonstrated that cold ischemic time (CIT) can be extended with machine perfusion in kidneys from deceased donors, without negatively impacting the kidney.1 This enables logistical elements of kidney transplantation, such as recipient preparation, to be addressed while the kidney is being machine perfused.
A total of 70 transplants were studied, including 21 marginal kidneys in the static cold storage group and 15 in the machine perfusion group. The time between the kidney arriving in the unit and transplantation was measured with recipient availability, time required for recipient assessment/optimization, and theatre accessibility all taken into consideration. Organs expected to have a short CIT were preserved with static cold storage and those expected to have longer CIT were preserved with hypothermic machine perfusion.
The study found that despite a significantly longer CIT in the machine perfusion group, there was no difference between the groups with respect to delayed graft function (DGF). The study also found that functional DGF (fDGF) and cardiorespiratory complications were significantly reduced in the machine perfusion group.
The authors hypothesize that the reduced rate of complications in the machine perfusion group may have been due to the optimization of recipients, which was made possible during the extended CIT provided by the use of machine perfusion, with no ill effects on the kidney.
1. Guy A et al. Hypothermic machine perfusion to optimize the timing of renal transplantation. Abstract presented at American Transplant Congress, Seattle USA, May 18–22, 2013.