There is a persistent organ shortage and patients die on the transplant waiting list in all countries. In the UK, there are approximately 6,000 patients waiting for a kidney transplant, and 1 patient dies each day while waiting. Therefore, many centres will nowadays accept organs from older and higher-risk donors to reduce the gap between the needed and available number of transplant organs. This policy change comes with a consequence as more ‘difficult’ organs may not function properly or cause complications.
Until recently, best practice for transporting kidneys from donor to recipient centre meant ice and a special preservation solution. “Previously, we were able to show that machine perfusion is better for the kidney than simple cold storage. Recently, however, science provided convincing data that the lack of oxygen between the removal and transplantation of the kidney was a major problem,” says Dr. Sijbrand Hofker, transplant surgeon at UMC Groningen and one of the study's researchers.
Therefore, COPE researchers from UZ Leuven, UMC Groningen and the University of Oxford developed a new strategy using kidney machine perfusion with continuous oxygenation before transplantation. This method was compared to perfusion without oxygen in a high-risk group of donor kidneys and the effect on clinical outcomes evaluated. Since a donor has two kidneys which are given to two different recipients, one kidney was treated with oxygenated perfusion and the other one without oxygen. Follow-up looked at immediate function, complications and results at one year after transplantation.