New method of preserving donated kidneys ‘could mean fewer organs wasted’

The technique could keep kidneys viable for longer and increase the number available for transplant.
The technique could keep kidneys viable for longer and increase the number available for transplant. The technique could keep kidneys viable for longer and increase the number available for transplant.

A new method of preserving donated kidneys could reduce the number of organs being discarded, experts have suggested.

Kidney Research UK revealed that around 100 kidneys could potentially be saved for transplant each year after being retrieved from donors.

Based on three years of data from NHS Blood and Transplant, the charity determined how many kidneys were considered clinically unsuitable for use.

But a new technique to better preserve the kidneys before surgery could keep them suitable for longer and increase the number of organs available for transplant.

The researchers believe their methods could be adopted within the next three years, directly addressing some of the logistical and operational issues across many NHS transplant settings.

Sandra Currie, chief executive of Kidney Research UK, said: “Patients wait on average over a year-and-a-half for a kidney transplant, some wait much longer and when they do receive the call, they can face a very difficult and tense time involving an urgent journey to the hospital to avoid the risk of missing out on a life-changing organ.

“Unfortunately, we know of many patients who have been called to hospital multiple times, only to be told the donor kidney cannot be used after all.

“One important reason for this is the very short time available currently to keep the kidney in good condition ahead of the surgery to transplant it.

“The research that we are funding aims to extend this critical window of opportunity from retrieval to transplant.”

Dr John Stone and Professor James Fildes from Pebble Biotechnology Laboratories in Alderley Park, Macclesfield, have made progress in keeping retrieved kidneys viable for longer.

The research uses a method, called normothermic perfusion, in which oxygenated blood is pumped through a kidney to simulate the flow of blood within an organ.

Cold storage of the kidney is currently the standard method, but the longer the organ is on ice, the greater the chances of damaging it. Perfusion could offer a solution to storage that does not impact the viability of the organ.

Current guidelines advise that perfusion should only be used to test the function of the kidney, ideally for less than three hours before the procedure causes injury to the organ.

But in an experimental setting, researchers have developed a new protocol with pig kidneys, with no evidence of injury at 24 hours.

They are now trying to extend perfusion into days.

Dr Stone said: “So far, we have been able to keep a kidney on the perfusion circuit for 24 hours without causing damage.

“With current guidelines advising just three to six hours of perfusion, our methods could allow more time so more patients receive their life-saving transplant and fewer precious organs go to waste.”

Inspiration for the project came from Dr Stone’s 11-year-old nephew, Luke, who received a kidney transplant from his father in May this year.

The average transplant lasts for up to 20 years, so Luke will probably need at least one more in his lifetime, meaning the work could be crucial to giving him a better outcome in the years ahead.

Dr Stone, senior scientist at Pebble Biotechnology Laboratories, said: “The clock is ticking as soon as you remove a kidney from a donor, you have a short amount of time before the organ is no longer viable.

“Transplant centres are under immense pressure to ensure the organ is not wasted but face operational challenges such as a lack of resources and sharing operating theatres with other departments, meaning that despite their best efforts, surgeons simply run out of time.”