Optimizing porcine donor kidney preservation with normothermic or hypothermic machine perfusion: A systematic review

Sarah Bouari, Özgür Eryigit, Ron W.F. de Bruin, Jan N.M. IJzermans, Robert C. Minnee*

*Corresponding author for this work

Research output: Contribution to journalReview articleProfessionalpeer-review

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We present an updated overview of the literature comparing normothermic with hypothermic machine perfusion in porcine kidneys. We conducted a systematic literature review in Embase, Medline Epub (Ovid), Cochrane Central, Web of Science, and Google Scholar on studies comparing normothermic (NMP) to hypothermic machine perfusion (HMP) in porcine kidneys. A meta-analysis was judged inappropriate because of heterogeneity in study design and perfusion methods. The quality of evidence of each included study was assessed. We included 8 studies. One out of 5 studies reported a significant difference in peak renal blood flow in favor of NMP. Oxygen consumption was significantly higher in NMP kidneys in 2 out of 5 studies. Peak creatinine clearance in NMP was significantly higher than that in HMP in 1 out of 6 studies. Two out of 4 studies reported a higher degree of epithelial vacuolation in kidneys receiving NMP over HMP. None of the studies found a significant difference between NMP and HMP in peak serum creatinine or graft survival after autotransplantation. The results need to be interpreted with caution in view of the diversity in perfusion protocols, the low quality of evidence, and the limited sample sizes.

Original languageEnglish
Pages (from-to)1308-1316
Number of pages9
JournalArtificial Organs
Issue number11
Early online date26 Jul 2021
Publication statusPublished - Nov 2021

Bibliographical note

Funding Information:
We thank the staff of the Erasmus MC medical library for assistance with the literature search.

Publisher Copyright:
© 2021 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.


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