PURPOSE OF REVIEW: The purpose of this review was to summarize the novel developments in preservation of older kidneys. RECENT FINDINGS: The importance of older donors as a source of renal grafts is increasing, with a concomitant increase of posttransplant failure. Preservation of kidneys retrieved from older donors through hypothermic machine perfusion reduces delayed graft function rate and increases long-term graft survival. Assessment of renal function and selection through biomarkers or perfusion criteria to predict posttransplant function are limited. Normothermic perfusion offers the benefit of reperfusion under ideal circumstances, thereby reducing ischemic injury while having the opportunity to test graft viability and preselect kidneys on graft-specific characteristics. Both preservation methods enable active treatment of the isolated graft prior to transplantation, with stem cells or pharmaceuticals. SUMMARY: Older kidneys are more prone to acute kidney injury during ischemic periods combined with an impaired ability to fully recover after transplantation. Novel preservation and resuscitation methods provide the opportunity to select transplantable kidneys better founded or even repair re-existing damage reducing the risk of impaired graft function and improving survival.
PURPOSE OF REVIEW: The purpose of this review was to summarize the novel developments in preservation of older kidneys. RECENT FINDINGS: The importance of older donors as a source of renal grafts is increasing, with a concomitant increase of posttransplant failure. Preservation of kidneys retrieved from older donors through hypothermic machine perfusion reduces delayed graft function rate and increases long-term graft survival. Assessment of renal function and selection through biomarkers or perfusion criteria to predict posttransplant function are limited. Normothermic perfusion offers the benefit of reperfusion under ideal circumstances, thereby reducing ischemic injury while having the opportunity to test graft viability and preselect kidneys on graft-specific characteristics. Both preservation methods enable active treatment of the isolated graft prior to transplantation, with stem cells or pharmaceuticals. SUMMARY: Older kidneys are more prone to acute kidney injury during ischemic periods combined with an impaired ability to fully recover after transplantation. Novel preservation and resuscitation methods provide the opportunity to select transplantable kidneys better founded or even repair re-existing damage reducing the risk of impaired graft function and improving survival.
Authors: Bilal Hussain; Vivek Kasinath; Joren C Madsen; Jonathan Bromberg; Stefan G Tullius; Reza Abdi Journal: ACS Nano Date: 2021-10-29 Impact factor: 18.027
Authors: Matteo Ravaioli; Maurizio Baldassare; Francesco Vasuri; Gianandrea Pasquinelli; Maristella Laggetta; Sabrina Valente; Vanessa De Pace; Flavia Neri; Antonio Siniscalchi; Chiara Zanfi; Valentina R Bertuzzo; Paolo Caraceni; Davide Trerè; Pasquale Longobardi; Antonio D Pinna Journal: Ann Transplant Date: 2018-01-12 Impact factor: 1.530
Authors: Paul V Ritschl; Julia Günther; Lena Hofhansel; Anja A Kühl; Arne Sattler; Stefanie Ernst; Frank Friedersdorff; Susanne Ebner; Sascha Weiss; Claudia Bösmüller; Annemarie Weissenbacher; Rupert Oberhuber; Benno Cardini; Robert Öllinger; Stefan Schneeberger; Matthias Biebl; Christian Denecke; Christian Margreiter; Thomas Resch; Felix Aigner; Manuel Maglione; Johann Pratschke; Katja Kotsch Journal: Front Immunol Date: 2018-08-24 Impact factor: 7.561