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Dissemination of a novel organ perfusion technique: ex vivo normothermic perfusion of deceased donor kidneys

Lookup NU author(s): Dr Emily ThompsonORCiD, Lucy BatesORCiD, Dr Ibrahim Ibrahim, Dr Avinash Sewpaul, Rodrigo Figueiredo, Professor Colin Wilson

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Abstract

© 2019 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc. Ex vivo normothermic perfusion (EVNP) technology is a promising means of organ preservation, assessment, and preconditioning prior to kidney transplantation, which has been pioneered by a single group. We describe the challenges of setting up clinical EVNP programs in 2 new centers, as well as early patient outcomes. Governance, training, and logistical pathways are described. In order to demonstrate safety and proficiency in this new technique, early patient outcomes are also described. Patient outcomes included the incidence of primary nonfunction, delayed graft function, graft and patient survival at 1 year. Contralateral kidneys undergoing static cold storage alone were used as a comparator group. Between March 2016 and July 2017, EVNP was performed on 14 kidneys from 12 donors (11 kidneys in center 1, 3 kidneys in center 2). Of the 14 kidneys that underwent EVNP, 12 organs were implanted into 10 recipients. Two pairs of kidneys were implanted as dual grafts and 1 kidney was implanted simultaneously with a pancreas. The remaining 7 kidneys were transplanted as single allografts. Seven pairs of kidneys were available for paired analysis comparing EVNP versus static cold storage. Graft and patient outcomes were comparable between the 2 preservation techniques. The introduction of a clinical EVNP service requires a careful multimodal approach, drawing on the expertise of specialists in transplantation, hematology, and microbiology. Both new clinical EVNP programs demonstrated proficiency and safety when a structured dissemination process was followed.


Publication metadata

Author(s): Chandak P, Phillips BL, Uwechue R, Thompson E, Bates L, Ibrahim I, Sewpaul A, Figueiredo R, Olsburgh J, Hosgood S, Nicholson ML, Wilson C, Callaghan CJ

Publication type: Article

Publication status: Published

Journal: Artificial Organs

Year: 2019

Pages: Epub ahead of print

Online publication date: 14/05/2019

Acceptance date: 07/05/2019

ISSN (print): 0160-564X

ISSN (electronic): 1525-1594

Publisher: Wiley-Blackwell

URL: https://doi.org/10.1111/aor.13499

DOI: 10.1111/aor.13499

PubMed id: 31087667


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