First clinical kidney transplantation series using brief bubble and direct surface oxygenation as alternative for membrane oxygenation during hypothermic machine perfusion

Abstract

Background: Active oxygen during hypothermic machine perfusion has the potential to improve mitochondrial preservation and subsequently decrease the harmful effects of ischemia reperfusion injury. Brief bubble, and subsequent surface oxygenation are an alternative oxygenation technique for membrane-oxygenated kidneys during hypothermic machine perfusion (HMP).

Methods: Between March 20, 2022, and June 13, 2022, 5 kidney grafts originating from 3 donors after circulatory death were oxygenated by bubble and surface oxygenation during HMP.

Results: No adverse events related to this new oxygenation technique were observed. All five recipients experienced no dialysis-dependency after transplantation with excellent initial graft function at 3 months after transplantation.

Conclusions: For the first time in human, this new oxygenation technique was successfully applied to 5 HMP-kidneys, originating from donation after circulatory death. If confirmed on larger scale cohorts, this innovative oxygenation technique, as alternative oxygenation technique for membrane-oxygenated kidneys, has the potential to be widely implemented because its simplicity and efficacy, and reducing economic and ecological costs by eliminating the need for a membrane oxygenator and oxygen source during transport.

Keywords: bubble and surface oxygenation; kidney; oxygenated hypothermic machine perfusion; preservation; transplantation.