Viability assessment and utilization of declined donor kidneys with rhabdomyolysis using ex vivo normothermic perfusion without preimplantation biopsy

Pearson, R., Asher, J., Jackson, A., Mark, P. B. , Shumeyko, V. and Clancy, M. J. (2021) Viability assessment and utilization of declined donor kidneys with rhabdomyolysis using ex vivo normothermic perfusion without preimplantation biopsy. American Journal of Transplantation, 21(3), pp. 1317-1321. (doi: 10.1111/ajt.16329) (PMID:33021059)

Abstract

The role of ex vivo normothermic perfusion (EVNP) in both organ viability assessment and reconditioning is increasingly being demonstrated. We report the use of this emerging technology to facilitate the transplantation of a pair of donor kidneys with severe acute kidney injury (AKI) secondary to rhabdomyolysis. Donor creatinine was 10.18 mg/dl with protein (30 mg/dl) present in urinalysis. Both kidneys were declined by all other transplantation units and subsequently accepted by our unit. The first kidney was perfused with red cell‐based perfusate at 37°C for 75 min, mean renal blood flow was 110 ml/min/100 g and produced 85 ml of urine. Having demonstrated favorable macroscopic appearance and urine output, the kidney was transplanted into a 61‐year‐old peritoneal dialysis dependent without complication. Given the reassuring information from the first kidney provided by EVNP, the second kidney was not perfused with EVNP and was directly implanted to a 64‐year‐old patient. The first kidney achieved primary function and the second functioned well after delayed graft function. Recipient eGFR have stabilized at 88.5 and 55.3, respectively (ml/min/1.73 m2), at 2 months posttransplant.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Clancy, Mr Marc and Mark, Professor Patrick and Pearson, Robert
• Authors: Pearson, R., Asher, J., Jackson, A., Mark, P. B., Shumeyko, V., and Clancy, M. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: American Journal of Transplantation
• Publisher: Wiley
• ISSN: 1600-6135
• ISSN (Online): 1600-6143
• Published Online: 05 October 2020
• Copyright Holders: Copyright © 2020 The American Society of Transplantation and the American Society of Transplant Surgeons
• First Published: First published in American Journal of Transplantation 21(3): 1317-1321
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher