Reviving and reconditioning donor kidneys outside the body before transplantation
Kidney transplantation is the best treatment for patients whose kidneys have failed and who are reliant on dialysis. However, due to the chronic shortage of organ donors in the UK, many people die whilst waiting for a kidney transplant. To address this problem we have developed a new technology called normothermic machine perfusion (warm perfusion). This involves warming the kidney to near body temperature by circulating an oxygenated red blood based solution through it before it is transplanted. Protective agents are added into the circulation to create a protective environment. The equipment used is the same technology employed in cardiac surgery but adapted to perfuse a kidney outside the body.
Warm perfusion has a number of advantages. First, early results have shown that this may improve how well the kidney works immediately after transplantation. We are testing this in a large clinical trial in four centres across the UK. Second, there are often concerns about the suitability of a kidney for transplantation. Warm perfusion enables us to make a functional assessment of the organ. This is of great advantage to the surgeon, ensuring that kidneys are not discarded unnecessarily and more can be used. Third, warm perfusion also allows us to administer therapies directly to the kidney to further improve its condition. This may be a more effective way to treat the kidney rather than administering therapies to the patient. We are testing a number of different treatments that can repair the kidney and hope to introduce these into clinical practice in the next few years.
Our research-in-action video explains more about our work: https://youtu.be/0X3P5S14Tho