Maschinenperfusion in der Nierentransplantation

The method of ex vivo machine perfusion as an innovative organ preservation technique, is currently experiencing a renaissance in light of the persistent shortage of donor organs. Due to this scarcity there is a growing acceptance of marginal donor organs for transplantation, which often display shorter graft survival and diminished organ function. Preservation via machine perfusion appears to provide a means to counteract the pre-existing damage of these organs, thus enhancing treatment quality and ensuring the optimal use of the potential donor pool. In addition to the hypothermic machine perfusion introduced in the 1970s, a plethora of other perfusion forms and techniques have been developed over the past decades in the quest for the ideal preservation method. Given the promising results from international studies, machine perfusion for donor kidneys is already routinely employed in many countries. In Germany, given the lengthy waiting lists and precarious donor situation, machine perfusion in the realm of kidney transplantation is gaining increased attention. The objective of this review is to provide an overview of the various modalities of machine perfusion and the outcomes of their clinical application in kidney transplantation as well as to discuss the current scientific endeavors and the implementation in Germany.