In what it says is an Australian first, Austin Health in Melbourne is using normothermic machine perfusion (NMP) to widen the potential pools of kidney transplants.
The health service says the technology that operates at body temperature rather than hypothermically will help address shortages through smarter use of kidneys that are donated.
Austin Health established a normothermic perfusion program for liver transplants in 2019 and has so far transplanted an additional 16 liver from organs thought to be non-viable.
“NMP helps us check and use kidneys that might otherwise be declined, turning potential missed opportunities into life-saving transplants,” said Medical Director of the Kidney Transplant Service Associate Professor John Whitlam.
By helping to identify organs that are safe to transplant, perfusion technology manages risks while expanding the donor pool, he said.
He cited a recent instance of when the Austin transplant team was working with a kidney that had been declined by all Victorian transplant centres due to concerns about function. However, the donated kidney performed well on NMP, which perfused it with oxygenated blood and nutrients, effectively “waking up” the kidney from cold storage “hibernation”.
After seeing excellent results from perfusion and some urine production, the clinical team decided it was safe for transplantation into a patient who had matched for the kidney.
Surgeon Associate Professor Bulang He, who performed the transplant said NMP assesses kidney function, identifying those with serious damage and avoiding unsuitable transplants.
“NMP provides a platform close to human physiological environment. The kidney receives red blood cell-based circulation with some nutrients, so the kidney could be rejuvenated, and further assessed for its quality and viability,” he said
“The shortage of donated kidneys remains a challenge. This technology helps to address this through smarter use of kidneys that are donated,” he added.
“Presently, our ability to assess kidneys prior to transplantation is quite limited. Normothermic perfusion will permit us to assess kidneys more comprehensively, allowing us to transplant some that we had assumed were not useable.”
Austin Health says it is establishing the Australian Centre for Transplantation Excellence and Research (ACTER), through which “we will seek excellence in transplantation innovation and clinical care.”
“This will be achieved by bringing together cutting-edge clinical practice, research, transplant-orientated operational systems, and active consumer participation.”