Machine perfusion effects on kidneys not suitable for transplantation.
Research type
Research Study
Full title
A study to determine the mechanism and effect of machine perfusion on cadaveric kidneys unsuitable for transplantation.
IRAS ID
168482
Contact name
Jay Nath
Contact email
Sponsor organisation
University Hospitals Birmingham NHS Foundation Trust
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Can we use Hypothermic Machine Perfusion (HMP) to improve the metabolism of kidneys deemed unsuitable for human transplantation?
When kidneys are removed from deceased individuals, there is a variable delay before the kidney can be transplanted into an appropriate patient. However during this time, the kidney is normally stored in a cool box (SCS) which helps to preserve the kidney before it is transplanted. During storage, damage can occur to the kidney which can mean it is slow to work following transplantation, or doesn't work at all.
An alternative to SCS is machine perfusion, which in addition to providing a cold environment, provides circulation of fluid through the kidney. Multiple studies have indicated this is beneficial and improves outcomes for these kidneys. Machine perfusion may also 'improve' less healthy kidneys, allowing extra time to assess the kidney and prepare the patient for surgery. The mechanism by which machine perfusion produces it's beneficial effect is not fully understood, but is likely to be multifactorial.
Metabolism has been demonstrated to play a key role during machine perfusion. We have demonstrated that the metabolic fingerprint of a kidney that works immediately is different to one that doesn't and that this can be determined pre-transplant from the concentration of metabolites in the perfusion fluid. We have demonstrated that in a pig model, the metabolism during perfusion can be manipulated with changes to both the fluid used and the perfusion parameters. The aim of this study is to utilise human kidneys that are not suitable for transplantation to determine the active metabolic pathways and manipulate the conditions of perfusion to try and convert their metabolism into one that is more favourable.
We hope this would ultimately lead to an improvement in the number and quality of transplanted organs.REC name
South West - Frenchay Research Ethics Committee
REC reference
15/SW/0052
Date of REC Opinion
2 Mar 2015
REC opinion
Favourable Opinion