Early results of a non-heartbeating donor (NHBD) programme with machine perfusion.
Freeman Hospital, Newcastle upon Tyne restarted their non-heartbeating donor (NHBD) programme in September 1998 using machine perfusion, due to early poor results with conventional cold storage (45% graft survival, phase II). Since then, 15 NHBD kidneys have been transplanted. The retrieval protocol consisted of in situ perfusion with a double balloon triple lumen cannula in Maastricht category II male donors age range 13-59 years. Mean primary warm ischaemic time was 24.8 min (range 10-44). All kidneys were machine perfused through a locally developed perfusion system. The viability was assessed by serial measurements of total GST (maximum acceptable limit of 200 units/l) and intrarenal vascular resistance (IRVR) was recorded. Fifteen of the 22 kidneys (68.62%) were transplanted. Delayed graft function (DGF) was seen in ten recipients (66.6%), two kidneys had immediate function (IF), one organ was exported, two recipients died of unrelated causes and a further seven kidneys were discarded (two had high tGST, two were infected and three had poor flow characteristics). In phase III, a success rate of 91.7% was thus achieved, which was better than the phase II period (P = 0.027, Fisher 2-tail test). Machine perfusion has been successfully introduced in phase III to the Newcastle NHBD programme and facilitates viability assessment of NHBD kidneys.
Balupuri
S
S
Liver and Renal Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK. balupuri.shlokarth@ncl.ac.uk
Buckley
P
P
Mohamad
M
M
Chidambaram
V
V
Gerstenkorn
C
C
Sen
B
B
Kirby
J
J
Manas
D M
DM
Talbot
D
D
D000293:Adolescent; D000328:Adult; D006323:Heart Arrest; D006801:Humans; D007511:Ischemia; D007668:Kidney; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D009926:Organ Preservation / Q000379:methods; D010477:Perfusion / Q000295:instrumentation / Q000379:methods; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods