title: Normothermic machine perfusion of the kidney: better conditioning and repair?
abstract: Kidney transplantation is limited by hypothermic preservation techniques. Prolonged periods of cold ischaemia increase the risk of early graft dysfunction and reduce long-term survival. To extend the boundaries of transplantation and utilize kidneys from more marginal donors, improved methods of preservation are required. Normothermic perfusion restores energy levels in the kidney allowing renal function to be restored ex vivo. This has several advantages: cold ischaemic injury can be avoided or minimized, the kidney can be maintained in a stable state allowing close observation and assessment of viability and lastly, it provides the ideal opportunity to add therapies to directly manipulate and improve the condition of the kidney. This review explores the experimental and clinical evidence for ex vivo normothermic perfusion in kidney transplantation and its role in conditioning and repair.
authors.affiliation: Department of Infection Immunity and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester, UK.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Hosgood
authors.affiliation: Department of General Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Ernest
authors.initials: E
authors.lastname: van Heurn
authors.affiliation: Department of Infection Immunity and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester, UK.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Nicholson
mesh_terms: D050377:Cold Ischemia; D046148:Donor Selection; D015316:Genetic Therapy; D006801:Humans; D007511:Ischemia / Q000473:pathology; D007668:Kidney / Q000502:physiology*; D016030:Kidney Transplantation / Q000295:instrumentation / Q000379:methods*; D009926:Organ Preservation / Q000295:instrumentation / Q000379:methods*; D019188:Organ Preservation Solutions; D010477:Perfusion / Q000295:instrumentation / Q000379:methods*; D033581:Stem Cell Transplantation; D013696:Temperature; D014019:Tissue Donors; D019172:Transplantation Conditioning
chemical_list: D019188:Organ Preservation Solutions
keywords: ex vivo normothermic perfusion; kidney; preservation; repair; transplantation conditioning