Eight Hour Continuous Normothermic Ex Vivo Kidney Perfusion is a Safe Preservation Technique for Kidney Transplantation: A New Opportunity for the Storage, Assessment and Repair of Kidney Grafts.

Background: Hypothermic kidney storage causes preservation injury and is poorly tolerated by renal grafts. We investigated whether static cold storage (SCS) can be safely replaced with a novel technique of pressure-controlled normothermic ex vivo kidney perfusion (NEVKP) in heart-beating donor kidney transplantation. Methods: Right kidneys were removed from 30 kg Yorkshire pigs in a model of heart-beating donation and either preserved in cold histidine-tryptophan-ketoglutarate (HTK) solution for 8h (n=5), or subjected to 8h of pressure-controlled NEVKP (n=5) followed by renal heterotopic autotransplantation. Results: During NEVKP physiologic perfusion conditions were maintained with low intrarenal resistance (IRR) and normal electrolyte and pH parameters. Aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) as injury markers were below the detectable analyzer range during the perfusion (

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