Kidney preservation
O’Callaghan J., Oniscu G., Leuvenink H., Friend PJ., Ploeg RJ.
Successful preservation of kidney allografts must counteract the cellular damage evolving after brain death or circulatory arrest. Static cold storage is the simplest method and has therefore been the most widely used. Several preservation fluids have been specially designed for this purpose, but a number of other fluids have been co-opted from other surgical specialties over the years. Hypothermic machine perfusion shows improved early graft function and graft survival compared to static cold storage, and particularly for extended criteria donor kidneys. Novel technologies are being developed to better assess the quality of the donor kidney and improve preservation, either using regional in situ normothermic perfusion or extracorporeal normothermic machine perfusion to allow further extension of the donor pool, without compromising outcomes.