O039 Subnormothermic acellular perfusion of human kidneys

Introduction The optimum conditions for normothermic machine perfusion (NMP) in kidney transplantation have yet to be determined. Traditionally, kidneys are perfused with a red blood cell (RBC) based solution at 37°C. NMP at a subnormothermic temperature without RBCs could reduce the harmful effects of haemolysis but still preserve kidney function. This study examines the effect of subnormothermic acellular machine perfusion (SNAP) in human kidneys. Methods Five pairs of human kidneys offered for research were included in the study. One of each pair was perfused with an oxygenated albumin-based solution with red cells (RBC) and the other without red blood cells (SNAP) at 32°C for 6h. After perfusion, kidneys were reperfused for 4h with a red cell-based solution at 37°C for assessment. Perfusion parameters and renal function were compared between groups. Results The mean age of the donors was 66±12y. The mean renal blood flow (RBF) was numerically higher in the SNAP group (156.5±57.1 vs 115.3±41.21ml/min/100g; P=0.063). RBC kidneys produced more urine but this did not reach statistical significance (154±159 vs 64±73ml; P=0.217). During reperfusion levels of RBF, urine output and percentage creatinine fall were similar between the groups (Creatinine fall; SNAP 66±18 vs RBC 74±16%; P=0.382). Conclusion This study suggests that SNAP is equivalent to perfusion with RBCs with no adverse effects on perfusion parameters. The removal of RBCs negates any detrimental effects of haemolysis and provides a simpler method of kidney perfusion.