Normothermic Kidney Perfusion: Current Status and Future Perspectives

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports Pub Date : 2025-09-01 DOI:10.1016/j.ekir.2025.06.041

Barbara Franchin , Leonie van Leeuwen , Matthew L. Holzner , Nicholas Chun , Lucrezia Furian , Paolo Cravedi

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Abstract

Normothermic machine perfusion (NMP), the most recent advancement in solid organ preservation, enables ex situ maintenance of grafts in a physiologically active state, offering a significant advantage over traditional cold storage methods. Whereas NMP is now widely adopted for clinical preservation of livers, hearts, and lungs, its application in kidney transplantation remains relatively limited. In this context, NMP holds promise for expanding the use of marginal donor kidneys by enhancing viability assessment and potentially restoring function in grafts that might otherwise be discarded. In addition, NMP provides a valuable platform for studying molecular markers of injury and recovery in human organs, as well as for delivering targeted therapies aimed at modulating immunologic or transcriptomic profiles. Despite its potential, broader clinical implementation is hindered by variability in perfusion devices, protocols, and perfusate compositions across centers, making cross-study comparisons challenging. This review examines the current landscape of kidney NMP and its emerging role in graft reconditioning.

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常温肾灌注：现状和未来展望

常温机器灌注（NMP）是固体器官保存的最新进展，能够使移植物在生理活性状态下保持原位，比传统的冷藏方法具有显著的优势。尽管NMP现已广泛应用于肝脏、心脏和肺的临床保存，但其在肾移植中的应用仍然相对有限。在这种情况下，NMP有望通过加强活力评估和潜在地恢复移植物的功能来扩大边缘供体肾脏的使用，否则移植物可能会被丢弃。此外，NMP为研究人体器官损伤和恢复的分子标记以及提供旨在调节免疫或转录组谱的靶向治疗提供了一个有价值的平台。尽管具有潜力，但由于灌注装置、方案和各中心灌注液成分的差异，阻碍了更广泛的临床应用，这使得交叉研究比较具有挑战性。本文综述了肾脏NMP的现状及其在移植物修复中的新作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney International Reports Medicine-Nephrology

CiteScore

7.70

自引率

3.30%

发文量

1578

审稿时长

8 weeks

期刊介绍： Kidney International Reports, an official journal of the International Society of Nephrology, is a peer-reviewed, open access journal devoted to the publication of leading research and developments related to kidney disease. With the primary aim of contributing to improved care of patients with kidney disease, the journal will publish original clinical and select translational articles and educational content related to the pathogenesis, evaluation and management of acute and chronic kidney disease, end stage renal disease (including transplantation), acid-base, fluid and electrolyte disturbances and hypertension. Of particular interest are submissions related to clinical trials, epidemiology, systematic reviews (including meta-analyses) and outcomes research. The journal will also provide a platform for wider dissemination of national and regional guidelines as well as consensus meeting reports.