Kidney assessment tool may increase available donor organs

Utilizing normothermic machine perfusion technology could increase the number of available donor kidneys, according to a study published in the British Journal of Surgery.

Currently, many donated-circulatory-death (DCD) kidneys are rejected for transplantation due to uncertainty about quality. Researchers in this study evaluated the feasibility of using normothermic machine perfusion (NMP) technology in assessing the quality of donor kidneys and identifying suitable matches for transplantation.

The study was split into two phases. In the first, declined DCD kidneys underwent a NMP analysis for 60 minutes and were graded on a scale of 1 to 5 on quality based on factors of macroscopic perfusion, renal blood flow and urine output. In the second phase, declined kidneys were assessed by NMP in terms of possible transplantation.

Results of phase one showed 18 of 42 DCD kidneys were declined, but 28 kidneys received a positive quality score following NMP and were considered suitable for transplantation. In phase two, 10 of 55 declined kidneys were assessed by NMP. Eight of these kidneys were declined because of poor flushing but five were transplanted successfully. Four of the five had initial graft function.

"Of five kidneys that would normally be discarded but were found suitable by the technique, four functioned immediately after transplantation," said lead author Sarah Hosgood, of the University of Cambridge, in the U.K. “NMP technology can be used to increase the number of DCD kidney transplants by assessing their quality before transplantation.”