A tale of two kidneys, and the case for machine perfusion in South Africa

Authors

  • N B Leech Division of General Surgery, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
  • Z Keyser Trauma Unit, Division of General Surgery, Tygerberg Academic Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  • D E Du Plessis Department of Urology, Tygerberg Academic Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  • V Soyizwapi Division of General Surgery, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
  • L Bertels Division of General Surgery, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
  • T du Toit Division of General Surgery, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i3b.1328

Keywords:

Renal Transplantation, Machine perfusion

Abstract

Extended-criteria donors (ECDs) are seen as a means of addressing the shortfall in solid-organ availability for transplant. However, the use of ECD kidneys is associated with a greater risk of primary non-function compared with standard-criteria donor kidneys, and a higher discard rate has been described internationally. There seems to be a lack of consensus in the consideration of ECD kidneys for transplant, with reliance often placed on the subjective assessment of individual clinicians. The following case examines the difference in the institutional decision-making process applied to two kidneys from a single donor, and provides an argument for the use of hypothermic machine perfusion in low- to middle-income countries as an efficacious and objective means of assessing ECD kidney suitability.

References

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Published

2024-04-24

Issue

Section

Supplement: Transplantation in SA

How to Cite

1.
Leech NB, Keyser Z, Du Plessis DE, Soyizwapi V, Bertels L, du Toit T. A tale of two kidneys, and the case for machine perfusion in South Africa. S Afr Med J [Internet]. 2024 Apr. 24 [cited 2025 Jan. 19];114(3b):e1328. Available from: https://samajournals.co.za/index.php/samj/article/view/1328

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