Hypothermic machine perfusion (HMP) of kidneys is a long-established alternative to static cold storage and has been suggested to be a better preservation method. Today, as our deceased donor profile continues to change towards higher-risk kidneys of lower quality, we are confronted with the limits of cold storage. Interest in HMP as a preservation technique is on the rise. Furthermore, HMP also creates a window of opportunity during which to assess the viability and quality of the graft before transplantation. The technology might also provide a platform during which the graft could be actively repaired, making it particularly attractive for higher-risk kidneys. We review the current evidence on HMP in kidney transplantation and provide an outlook for the use of the technology in the years to come.
Keywords: delayed graft function; donation after brain death; donation after circulatory death; expanded criteria donors; extended criteria donors; graft quality; history of machine perfusion; hypothermic machine perfusion; kidney transplantation; organ preservation; perfusate biomarkers; renal resistance; viability assessment.
© 2015 Steunstichting ESOT.