Main
ischemia, allograft dysfunction, bile duct, acute kidney injury
ISCHEMIA, KIDNEY, COLD, COMPLICATIONS
Kidney transplantation is one of the major successes of modern medicine in the 20th century, transforming and extending the lives of many thousands of patients. However, a longstanding limitation of kidney transplantation is that the supply of transplantable organs does not meet demandFor more than 50 years, the traditional method of pre-transplant kidney preservation has been static cold storage (SCS) in iceDCD takes place after cessation of cardiac activity in the donor, leading to an inevitable period of warm ischemia, which can cause acute kidney injury. In addition, DCD kidneys are more susceptible to cold storage injuryNormothermic machine perfusion (NMP) is an emerging technique that uses cardiopulmonary bypass technology with extracorporeal membrane oxygenation to perfuse kidneys with a warmed and oxygenated red-cell-based plasma-free solutionThe first randomized controlled trial of NMP in liver transplantation demonstrated that, compared to conventional SCS, NMP reduced early allograft dysfunction. There was no effect on bile duct complications, graft survival and patient survivalOur non-randomized pilot study in kidney transplantation suggested that a 1-h period of NMP, delivered at the end of the cold storage period and immediately before transplantation, reduced the rate of DGF in extended criteria donor kidneys