Ethically increasing efficient organ procurement can save many lives, as more than 100,000 people are currently on an organ transplant list. A person gets added to a transplant list every eight minutes, and 5,600 Americans die every year waiting for an organ. Most of these individuals — a resounding 86% — are in need of a kidney.
Kidneys may often be disqualified for procurement based on cold ischemia time (CIT). However, research has shown that CIT is not the most appropriate metric for assessing kidney function. Innovative methods such as normothermic regional perfusion (NRP) have arisen that can help surgeons determine organ quality more accurately and reduce the transplant list burden.
Kidney Quality Should Determine Viability
Many organs are discarded because of CIT, namely because CIT is associated with higher rates of delayed graft function and primary nonfunction. However, a study from Kidney Medicine Journal states that CIT should not be the basis for discarding an organ, because the quality of the kidney matters more than its cold ischemic time.
The study analyzed the outcomes of over 37,000 kidney recipients and determined that the kidney donor profile index (KDPI) played a more important role in determining kidney quality than cold ischemia time. “The effect of cold ischemia time is modest,” they reported. “Transplant programs should not consider prolonged cold ischemia time alone as a predominant reason to decline an organ, especially with a KDPI<85%.”
How NRP Can Help Surgeons Assess Kidney Quality
Normothermic regional perfusion (NRP) is providing greater opportunities for organ recovery by reducing the incidence of ischemic injury, enabling increased organ procurement from DCD donors, and allowing surgeons to assess organ function in real time.
NRP perfuses oxygenated blood back into organs, enabling their reanimation while decreasing the risk of injury and preserving energy storage. For abdominal organs like the kidney, a surgeon can evaluate viability directly during the procurement phase, enabling the possibility for more kidneys to be deemed fit for transplantation.
How NRP Can Improve Your Transplant Program
If you’re interested to know how NRP can improve your transplant program, especially for in-demand organs like kidneys, get in touch with us today. NRP is altering the landscape for transplantation, and it’s accessible for most hospitals — ICUs already have the ECMO or ECOS equipment necessary to conduct NRP. The University of Cincinnati reported that NRP allowed them to “wipe out” their waiting list for livers, and Current Opinion in Organ Transplantation cites “excellent early outcomes with liver and kidney transplantation” that are driving the increased usage of NRP.
SpecialtyCare is one of the largest providers of perfusion services in the country, supporting over 75,000 cardiac procedures each year and deploying 430 perfusionists nationwide. We’re experts in NRP, offering a response time in as little as 30 minutes and team availability twenty-four hours a day, seven days a week, 365 days a year. We can assist with preparation, procurement, logistics, transport, and transplant, integrating seamlessly with your team throughout the process. Contact us today to learn more about how we can help you transplant more kidneys and continuously improve outcomes.
