The First Case of Ischemia-Free Kidney Transplantation in Humans

Xiaoshun He; Guodong Chen; Zebin Zhu; Zhiheng Zhang; Xiaopeng Yuan; Ming Han; Qiang Zhao; Yitao Zheng; Yunhua Tang; Shanzhou Huang; Linhe Wang; Otto B van Leeuwen; Xiaoping Wang; Chuanbao Chen; Liqiu Mo; Xingyuan Jiao; Xianchang Li; Changxi Wang; Jiefu Huang; Jun Cui; Zhiyong Guo

doi:10.3389/fmed.2019.00276

The First Case of Ischemia-Free Kidney Transplantation in Humans

Front Med (Lausanne). 2019 Dec 11:6:276. doi: 10.3389/fmed.2019.00276. eCollection 2019.

Authors

Xiaoshun He^{1

2

3}, Guodong Chen^{1

2

3}, Zebin Zhu^{1

2

3}, Zhiheng Zhang^{1

2

3}, Xiaopeng Yuan^{1

2

3}, Ming Han^{1

2

3}, Qiang Zhao^{1

2

3}, Yitao Zheng^{1

2

3}, Yunhua Tang^{1

2

3}, Shanzhou Huang^{1

2

3}, Linhe Wang^{1

2

3}, Otto B van Leeuwen⁴, Xiaoping Wang^{1

2

3}, Chuanbao Chen^{1

2

3}, Liqiu Mo⁵, Xingyuan Jiao^{1

2

3}, Xianchang Li^{1

2

3

6}, Changxi Wang^{1

2

3}, Jiefu Huang^{1

7}, Jun Cui⁸, Zhiyong Guo^{1

2

3}

Affiliations

¹ Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
² Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China.
³ Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China.
⁴ Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
⁵ Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁶ Immunobiology and Transplant Science Center, Houston Methodist Research Institute, Houston, TX, United States.
⁷ Peking Union Medical College Hospital, Beijing, China.
⁸ MOE Key Laboratory of Gene Function and Regulation, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, China.

Abstract

Background: Ischemia-reperfusion injury (IRI) has been considered an inevitable event in organ transplantation since the first successful kidney transplant was performed in 1954. To avoid IRI, we have established a novel procedure called ischemia-free organ transplantation. Here, we describe the first case of ischemia-free kidney transplantation (IFKT). Materials and Methods: The kidney graft was donated by a 19-year-old brain-dead donor. The recipient was a 47-year-old man with end-stage diabetic nephropathy. The graft was procured, preserved, and implanted without cessation of blood supply using normothermic machine perfusion. Results: The graft appearance, perfusion flow, and urine production suggested that the kidney was functioning well-during the whole procedure. The creatinine dropped rapidly to normal range within 3 days post-transplantation. The levels of serum renal injury markers were low post-transplantation. No rejection or vascular or infectious complications occurred. The patient had an uneventful recovery. Conclusion: This paper marks the first case of IFKT in humans. This innovation may offer a unique solution to optimizing transplant outcomes in kidney transplantation.

Keywords: ischemia-free kidney transplantation; ischemia-free organ transplantation; ischemia-reperfusion injury; kidney transplantation; normothermic machine perfusion.

Publication types

Case Reports