A paired study comparing the efficacy of renal preservation by normothermic autologous blood perfusion and hypothermic pulsatile perfusion.

THE REDUCTION in metabolic rate effected by hypothermia constitutes the central tenet of traditional organ preservation. The antithesis of this approach is to provide for metabolic demand during normothermic preservation. This latter strategy has two potential benefits. First, if metabolic requirements are met during preservation, then longer preservation with better posttransplant function may be achieved than for an organ suffering prolonged cold ischemia. Second, normothermic perfusion may allow ex vivo organ function to be restored and therefore assessed prior to transplantation. This may provide a basis for viability assessment, thus reducing the risks of primary nonfunction of allografts. POPS (pulsatile organ perfusion system) (Transmedics, Boston, Mass, USA) is a new warm perfusion system for organs, using blood as the principle component of the perfusate. The aim of this study was to compare the efficacy of preservation of porcine kidneys by normothermic autologous blood perfusion and hypothermic machine perfusion (RM3 system, Waters, Mass, USA.)