The process is actually relatively simple. The doctors flush the kidney with oxygenated blood prior to the transplant surgery. This process, known as normothermic perfusion, is seen to reverse the damage done to the organ by storing them at low temperatures while awaiting the surgical operation. The oxygenated organ performs better immediately after the grafting procedure. Kidneys that restore full function early after the implant, have been shown to last longer and perform better.
It is thought that the new process can not only increase lifespan of the patient, but also reduce rejection rates. The current lifespan of someone with a grafted kidney is only 10-15 years, and while on one hand, the process seems like common sense, it’s a wonder no one thought of it 20 years ago. On the other hand, it is great news for anyone awaiting a kidney transplant.
Professor Mike Nicholson, lead researcher for Kidney Research UK, said:
“Normothermic perfusion allows us to gradually reintroduce blood flow to donor kidneys outside of the body and in a controlled way … This reverses much of the damage caused by cold storage, while offering us a unique opportunity to treat the organs with anti-inflammatory agents and other drugs before going on to complete the transplant procedure …In short, we’re able repair and revive damaged kidneys in a way that would otherwise be impossible.”
So far, only one of 17 kidneys transplanted using the normothermic perfusion showed signs of delayed function. This delay in the organ coming back to life is seen as a primary cause of rejection and it is not uncommon for delayed function to occur in upto fifty percent of kidney transplant patients.
Professor Nicholson continues that :
There’s often great reluctance among health professionals to use kidneys from marginal donors, as there’s no way to establish how much damage has been caused to the organs and whether or not they will work … As a result, these organs are often discarded as a precaution, rather than taking the risk of using them for transplants … Normothermic perfusion allows us to perform a crucial viability check on these kidneys, pumping them with blood to confirm whether or not they function adequately enough to be used for transplantation.”
In the UK, a mere 3000 transplants are performed each year, while some ninety percent of all patients waiting for donor organs are those needing replacement kidneys. More than half of those who die from uncontrolled cardiac arrest are unsuitable for transplantation and must be discarded, so it is thought that the normothermic perfusion process can cut the waiting list by more than 10%. This could have a profound effect on the NHS, which currently spends more than three billion per year treating patients waiting for replacement kidneys.
For example, the average cost of treating a patient waiting for a new kidney is some £30,000 ($45,000) per year, the transplant operation whether successful or not costs some £42,000 ($63,000), while the cost of treating a patient with a donated organ implanted is reduced to around £6,500 per year, meaning that a patient who is off dialysis and using a donated organ is saving the health service some £24,000 ($36,000) per year.
Charles Kernahan, Chief Executive of Kidney Research UK, said:
“This project represents a major step in the fight against kidney disease. Although transplantation is by no means a cure for kidney failure, it is by far the best treatment method available to us at this time … In developing a process that not only maximises the quality of kidneys taken from marginal donors but could also lead to hundreds more transplants being carried out each year, our researchers have given fresh hope to the 7,000 people in the UK currently waiting for a kidney.”
Kidney Research UK is now appealing for more funding in order to take normothermic perfusion on to clinical trials. They are accepting donations on their website
Written by Rupert Shepherd