One-Year Outcome of HMP(O2)-Perfused Kidneys After the Implementation of a National Machine Perfusion Service

Purpose: In October 2022, a national hypothermic machine perfusion (HMP)
service was implemented for all ECD and DCD kidneys procured and transplanted
in Belgium. The aim of this study is to evaluate the functional one-year outcome of
these kidneys continuously perfused with HMP.
Methods: A retrospective analysis was performed on 242 HMP-perfused kidney
transplantations (DBD+DCD) performed between 1/10/2022 and 30/09/2023 of
which 49 from ECD and 193 from DCD donors. The LifePort Kidney Transporter
(®Organ Recovery Systems) was used for all MP procedures. Active oxygenation
realized by preceding bubble O2 ofthe perfusate and continuous surface O2 during
HMP was applied to all DCD>50yrs and in study context in 14 DCD≤50yrs$. Donor
demographics and functional outcome were analyzed.
Results: The 1-year functional outcome according to donor type is illustrated in Table
1. The reasons for graft loss (13/242) were primary nonfunction (n=1), rejection
(n=1), donor-transmitted infection (n=1), graft infection (n=1), arterial thrombosis
(n=1), venous thrombosis (n=2), unknown (n=2) and patient’s death (n=4).
Conclusions: Functional outcome of HMP-preserved kidneys after the introduction
of a national HMP program for all ECD and DCD kidneys is excellent and reassures
transplant teams in their decision-making process when such higher-risk kidneys
are offered for transplantation.