163 Subnormothermic acellular machine perfusion for prolonged preservation of human kidneys

Abstract In kidney transplantation, normothermic (37°C) machine perfusion (NMP) technology permits kidneys to be preserved ex vivo in a metabolically active state to assess viability prior to transplant. Prolonging the preservation interval using NMP technology could allow better matching and allocation of kidneys and provide an opportunity for organ modification and repair. Here, we propose subnormothermic (32°C) acellular perfusion (SNAP) without the addition of an oxygen carrier as a new approach that reduces oxygen requirements of the kidney graft while preserving sufficient metabolism to maintain viability. In total, 24 human kidneys were perfused for 6h, 12h or 24h using SNAP or preserved on ice. After preservation, all kidneys were reperfused for 4h with a RBC-based solution at 37°C for assessment. We demonstrate that kidneys can be successfully preserved with SNAP for up to 24h, showing viability and functionality at reperfusion and a preserved renal morphology on histological assessment. This work provides a clinically feasible strategy to extend the preservation time during kidney transplantation.