Preserving organ function of marginal donor kidneys

PhD ceremony: Mr. C. Moers, 16.15 uur, Aula Academiegebouw, Broerstraat 5, Groningen

Dissertation: Preserving organ function of marginal donor kidneys

Promotor(s): prof. R.J. Ploeg

Faculty: Medical Sciences

Marginal organ donors can be arbitrarily defined as patients of advanced age and/or those donors who have above-average concomitant morbidity such as impaired renal function, cardiovascular disease, hypertension, or diabetes mellitus. In addition, organs recovered after cardiocirculatory death, are also usually considered marginal donor grafts. Kidneys derived from marginal donors may have an impaired post-transplant organ function, with an elevated risk of developing delayed graft function. Also, the risk of primary non-function will be increased. Although many marginal organs will eventually show acceptable function, long term graft survival can be substandard as well. This thesis comprises clinical and pre-clinical studies that aim to quantify the impact of donor characteristics on post-transplant outcome, and to investigate the effect of interventions before or during organ preservation to better conserve organ quality prior to transplantation. In addition, two studies aim to predict aspects of transplant outcome by measuring biomarkers in donor plasma and in machine preservation solution, or by assessing machine perfusion characteristics. Although the findings of these studies may pertain to all types of donor kidneys, they are particularly applicable to renal grafts recovered from marginal donors. Since the outcome of such transplants is often substandard, any additional information on organ quality, as well as measures that will better preserve graft function are most relevant for marginal kidneys.