ROLE OF MACHINE PERFUSION PRESERVATION IN KIDNEY-TRANSPLANTATION FROMNONHEARTBEATING DONORS

The shortage of kidneys for transplantation is a universal problem. If the viability of the kidney can be assured, organ procurement from no n-heartbeating donors will be greatly enhanced. This study evaluates t he usefulness of machine perfusion preservation parameters as an index of kidney graft viability. We report our experience with 77 non-heart beating donor kidneys preserved with machine perfusion technique. Sixt y-eight grafts demonstrated excellent perfusion (mean flow 0.79 ml/min /g) with low vascular resistance (55.4 mmHg/ml/min/g). Early graft fun ction occurred in all of these kidneys. Nine kidneys demonstrated poor perfusion (mean flow 0.35 ml/min/g) and elevated pressures with high vascular resistance (132.5 mmHg/ml/min/g). Four kidneys with poor perf usion and elevated pressures was discarded after perfusion. The four m ates of these discarded at our center were primarily non-functional wh en transplanted at another transplant center. All five of the poorly p erfused kidneys experienced primary nonfunction. We conclude that the use of quantitative values of perfusion flow (>0.4 ml/min/g) and no in creased pressure pattern allow safe utilization of grafts from non-hea rtbeating donors and can predict early postoperative function.