Evidence map›Paper›PMID 41474605›Full record

ArticleArtificial organs2026

Optimizing Prolonged (6 h) Normothermic Machine Perfusion of Donor Kidneys (PROPER Study).

Asel S Arykbaeva, Veerle A Lantinga, L Leonie van Leeuwen, Marten Engelse, Ton J Rabelink, Jesper Kers, Jason B Doppenberg, Volkert A L Huurman, Robert A Pol, Robert C Minnee and 5 more

Abstract read
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In one paragraph

Article in Artificial organs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Asel S ArykbaevaDepartment of Surgery, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
Veerle A LantingaDepartment of Surgery, University of Groningen, University Medical Center Groningen (UMCG) Comprehensive Transplant Center, Groningen, the Netherlands.
L Leonie van LeeuwenDepartment of Surgery, University of Groningen, University Medical Center Groningen (UMCG) Comprehensive Transplant Center, Groningen, the Netherlands.ORCID https://orcid.org/0000-0003-4666-2993
Marten EngelseLUMC, Transplant Center, Leiden, the Netherlands.
Ton J RabelinkLUMC, Transplant Center, Leiden, the Netherlands.
Jesper KersLUMC, Transplant Center, Leiden, the Netherlands.
Jason B DoppenbergLUMC, Transplant Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0001-7375-0839
Volkert A L HuurmanDepartment of Surgery, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
Robert A PolDepartment of Surgery, University of Groningen, University Medical Center Groningen (UMCG) Comprehensive Transplant Center, Groningen, the Netherlands.
Robert C MinneeDepartment of Surgery, Division of Hepatopancreatobiliary and Transplant Surgery, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Henri G D LeuveninkDepartment of Surgery, University of Groningen, University Medical Center Groningen (UMCG) Comprehensive Transplant Center, Groningen, the Netherlands.
Rutger J PloegLUMC, Transplant Center, Leiden, the Netherlands.
Cyril MoersDepartment of Surgery, University of Groningen, University Medical Center Groningen (UMCG) Comprehensive Transplant Center, Groningen, the Netherlands.ORCID https://orcid.org/0000-0001-8014-8387
Dorottya K de VriesDepartment of Surgery, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
Ian P J AlwaynDepartment of Surgery, Leiden University Medical Center (LUMC), Leiden, the Netherlands.ORCID https://orcid.org/0000-0003-0603-9849

Funding

Nierstichting BHF1P02
6 · The paper itself

Abstract

backgroundEx situ normothermic machine perfusion (NMP) holds great promise in preserving and concomitantly evaluating the viability of kidney grafts. NMP for 1 to 2 h has been shown to be feasible and safe, demonstrating no adverse impact on early graft function. Prolonging the duration of NMP offers an extended timeframe for evaluation, besides creating a window for pretransplant therapeutical interventions. This study aimed to assess the feasibility of extending the duration of perfusion to 6 h.

methodsWe investigated the prerequisites to extend the warm perfusion of donor kidneys safely for up to 6 h. Human donor kidneys deemed unsuitable for transplantation were included for experimental NMP. Throughout the perfusion process, we assessed metabolic activity, as well as the extent of biochemical, hemolytic, and histological injury through biopsy, urine, and perfusate analyses. Stepwise alterations were made to the protocol accordingly.

resultsAn analysis of 30 discarded kidneys revealed that improvements in erythrocyte quality, oncotic pressure, and correction of electrolyte imbalances facilitated the achievement of steady flow volumes and ensured a favorable macroscopic appearance of the graft. Extending the perfusion period to 6 h displayed preserved renal viability and stable histological characteristics.

conclusionsThe presented protocol shows prolonging NMP of donor kidneys to 6 h is feasible. We have implemented pivotal elements including the use of fresh (≤ 7 days) washed red blood cells, the addition of albumin, and urine recirculation, resulting in a stable and balanced perfusion. Ongoing refinements are necessary to enable the clinical application of a more prolonged NMP.

Indexed as

KidneyKidney TransplantationOrgan PreservationPerfusionAdultFeasibility StudiesFemaleHumansMaleMiddle AgedTime FactorsTissue Donors

Identifiers

PMID41474605
PMCPMC13125389

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