Toward the optimal utilization of renal normothermic machine perfusion

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    The shortage of organ donors has significantly increased waiting times for kidney transplants. To address this issue and expand the donor pool, suboptimal kidneys—often from older donors or those exposed to prolonged oxygen deprivation—are being increasingly used. However, these kidneys are more prone to damage, leading to a higher risk of post-transplant complications. Normothermic machine perfusion (NMP) has emerged as a promising solution, capable of restoring cellular metabolism in an isolated circuit. This technology enables pre-transplant organ evaluation and provides a platform for ex vivo interventions to improve kidney quality. Despite its growing use and the availability of commercial NMP devices, key questions remain about which markers measured during NMP best predict successful post-transplant outcomes and how to optimize perfusion protocols to better support kidney function. This thesis explored ways to enhance perfusion protocols to preserve renal integrity during ex vivo perfusion. It also integrated magnetic resonance imaging (MRI) with NMP, using porcine and discarded human donor kidneys as models. MRI offers a non-invasive and efficient alternative to traditional methods like tissue histopathology for assessing graft quality. Additionally, this thesis compared the differences between in vivo and ex vivo renal physiology to deepen our understanding of kidney function during NMP.
    Originele taal-2English
    KwalificatieDoctor of Philosophy
    Toekennende instantie
    • Rijksuniversiteit Groningen
    Begeleider(s)/adviseur
    • Moers, Cyril, Supervisor
    • Leuvenink, Henri, Supervisor
    • Keller, Anna Krarup, Co-supervisor, Externe Persoon
    Datum van toekenning5-mrt.-2025
    Plaats van publicatie[Groningen]
    Uitgever
    Gedrukte ISBN's978-94-6473-685-4
    DOI's
    StatusPublished - 2025

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