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Changing the way we transplant kidneys, forever Maria Thompson

15 January 2019

A Kidney Research UK-funded trial aiming at improving the success rates of transplant operations, has reached the half way point.

Led by Professor Mick Nicholson at Cambridge University, the project is testing a technique called normothermic perfusion, which revives a donor kidney and repairs much of the damage caused by it being on ice – all before transplant.

Mike Nicholson, Normothermic Perfusion
Professor Mike Nicholson is researching how normothermic perfusion can be used to preserve donor kidneys

If the trial is a success normothermic perfusion will increase the use of marginal donor kidneys which would have been discarded, potentially enabling around 250 more kidney transplants per year, reducing waiting times for transplants.

The project received one of the largest grants ever given by Kidney Research UK and involves three major UK hospitals.

Professor Mike Nicholson said: “If both parts of the project are successful we hope that normothermic perfusion will be adopted by all transplant units nationwide.

“Our previous findings suggest that the technique could not only reduce rejection rates but also increase the lifespan of transplanted kidneys, which currently only last around 10 to 15 years. It could also cut the transplant waiting list by 10% or more.

“We hope that this new, larger trial will give us the definitive answers we need – in fact it could completely change the way kidney transplants are done and delivered.”

Normothermic perfusion involves flushing donor kidneys with warm, oxygenated blood for about an hour, prior to transplantation.

It allows surgeons to gradually reintroduce blood flow to donor kidneys outside the body and in a controlled way. This reverses much of the damage caused by the conventional method of storing them in ice, while also being able to treat the organs with anti-inflammatory agents and other drugs before going on to complete the transplant procedure.

Normothermic perfusion also allows doctors to check the viability of the organ.

Currently, if there are any doubts about the kidney, it is discarded – this happens to 10 to 15% of potential donor kidneys. By allowing doctors to test kidney function before transplantation, normothermic perfusion can make many more donor kidneys available.

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