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Normothermic machine perfusion for the assessment and transplantation of declined human kidneys from donation after circulatory death donors

Lookup NU author(s): Professor Colin Wilson



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


© 2017 BJS Society Ltd. Background: A significant proportion of donation after circulatory death (DCD) kidneys are declined for transplantation because of concerns over their quality. Ex vivo normothermic machine perfusion (NMP) provides a unique opportunity to assess the quality of a kidney and determine its suitability for transplantation. Methods: In phase 1 of this study, declined human DCD kidneys underwent NMP assessment for 60min. Kidneys were graded 1-5 using a quality assessment score (QAS) based on macroscopic perfusion, renal blood flow and urine output during NMP. In phase 2 of the study, declined DCD kidneys were assessed by NMP with an intention to transplant them. Results: In phase 1, 18 of 42 DCD kidneys were declined owing to poor in situ perfusion. After NMP, 28 kidneys had a QAS of 1-3, and were considered suitable for transplantation. In phase 2, ten of 55 declined DCD kidneys underwent assessment by NMP. Eight kidneys had been declined because of poor in situ flushing in the donor and five of these were transplanted successfully. Four of the five kidneys had initial graft function. Conclusion: NMP technology can be used to increase the number of DCD kidney transplants by assessing their quality before transplantation.

Publication metadata

Author(s): Hosgood SA, Thompson E, Moore T, Wilson CH, Nicholson ML

Publication type: Article

Publication status: Published

Journal: British Journal of Surgery

Year: 2018

Volume: 105

Issue: 4

Pages: 388–394

Print publication date: 01/03/2018

Online publication date: 06/12/2017

Acceptance date: 21/09/2017

Date deposited: 06/03/2018

ISSN (print): 0007-1323

ISSN (electronic): 1365-2168

Publisher: John Wiley and Sons Ltd


DOI: 10.1002/bjs.10733


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