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Researchers from the Netherlands report in the New England Journal of Medicine that they have found a way to increase the chances that kidneys from deceased donors will succeed after transplant, thus sparing patients from expensive follow-up care or even another organ transplant. In the largest and first study of its kind, doctors compared two existing ways of preserving kidneys taken from deceased donors - in cold storage in an ice pack, or via cold perfusion, which involves hooking the kidney up to a machine that pumps a chilled blood-like solution throughout the organ. (See the top 10 medical...
Currently, about 62% of kidneys transplanted each year in the U.S. are harvested from deceased donors; many of those organs cannot be transplanted if they aren't correctly preserved. Past studies have shown that a kidney must be transplanted within 24 hours to lessen the risk of failure in its new host. Most organ centers handle kidneys pre-transplant by washing, then submerging them in a preservation solution and melting ice. But recent evidence has suggested that perfusion machines, which have been around since the 1970s, might do a better job of maintaining the organs and perhaps promote survival once...
...Rutger Ploeg, professor of surgery at the University Medical Center of Groningen in the Netherlands, set up a trial involving patients from the international organ exchange group called Eurotransplant. Researchers procured a pair of kidneys from 336 deceased donors and, within 24 hours, placed one from each pair in cold storage, and attached the other to a LifePort Kidney Transporter perfusion machine. The kidneys were then transplanted into 672 recipients. Among the patients who received a cold-stored kidney, 89 developed a condition called delayed graft function in which the kidney fails to function immediately after transplant. Only...
Ploeg notes that these results should help doctors make the most of the kidneys that are currently available. Ploeg's study found that machine-preserved kidneys performed consistently better than cold-stored kidneys no matter who the donor. In other words, perfusion proved beneficial, even when the organ donor was older or had other issues that would make the tissue marginal for transplant. That's especially important, since in recent years, the quality of donated kidneys has declined, due in part to the typical donor's advanced age and increase in accumulated health problems and diseases. Given the dwindling...
About half of U.S. transplant organ facilities currently have perfusion machines, according to estimates by the National Kidney Foundation, something that may change based on the results of the new study. "If we can take the kidneys that we have and increase the likelihood that they will work [better], then that's going to be marvelous," says Becker of the National Kidney Foundation. And, if the study results hold, that benefit could extend to other transplant tissue as well. "We're going to see interest in utilizing this principle for other groups of organs," says Dr. Stefan Tullius, chief...