Device keeps donor organs fresher

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A special storage machine could be better than ice for keeping donor kidneys fresh for transplantation, say scientists.
Kidneys were less likely to fail within a year when stored this way, compared with being packed in ice for transportation.
The European trial involving 366 pairs of kidneys, was published in the New England Journal of Medicine.
Advice on the use of the machines in the NHS are expected this month.



More than 1,300 transplants involving kidneys from deceased donors are carried out every year in the UK.
As soon as the patient dies, the organ will start to deteriorate, and it is crucial that this process is halted, or at least slowed down, while the transplant operation is organised and the kidney is transported to the right hospital, which can be hundreds of miles away.
Traditionally, a kidney will be flushed out with a special solution, then put into an ice filled box to keep it "fresh".
However, in recent years, "cold infusion machines" have been developed, which are attached to the blood vessels supplying the kidney, and then push a steady flow of cool solution around them.
The study, run across The Netherlands, Belgium and Germany, directly compared the performance of both methods by taking a pair of donor kidneys, putting one "on ice", and the other into a machine.
Two main indicators of success or failure were then measured, firstly, the survival of the transplanted organ in the 12 months after surgery, and secondly, a delay in the functioning of the donor kidney once placed into the recipient. One-year survival was better in the machine stored kidneys - 94% compared with 90%, and 70 out of 336 recipients developed "delayed function" compared with 89 out of 336 who received an ice-stored kidney.

Professor Rutger Ploeg, from the University Medical Center in Groningen, who led the trial, said it was a "truly important" finding.
He said: "This trial shows us that, regardless of the health of the donor, by using machine preservation we can ensure that there will be more kidneys available for transplantation and that they will be in better health."
In the UK, ice storage is still the most commonly-used method, although some transplant centres are testing the potential of the machines.
The body responsible for evaluating new technologies and drugs for the NHS, the National Institute for Health and Clinical Excellence, is due to give its initial verdict on their use later in January, although its deliberations did not involve the latest study.
Mr Keith Rigg, vice-president of the British Transplantation Society, and a transplant surgeon at the Nottingham University Hospitals NHS Trust, said that while the evidence was "encouraging", their introduction would be expensive, and would need to be embraced by all hospitals involved in transplantation, not just a few. "There are significant logistical issues," he said, "and not just increases in infrastructure, but also in personnel trained to use the machines properly, who would need to be available 24 hours a day."