COOLING the body of a deceased organ donor by 2°C less than normal body temperature could increase the efficiency of kidney transplantation, a new study has reported.
At present, approximately 40% of kidney transplant recipients are reported to experience delayed graft function. Results from the new study, however, showed that inducing a mild state of hypothermia in deceased organ donors reduced the likelihood of delayed graft function in kidney transplant recipients by 38%. In addition, the free intervention may allow organs that would otherwise be rejected to be considered for transplantation.
Targeted temperature management, also known as therapeutic hypothermia, is currently used in the treatment of patients with stroke, asphyxia, and certain types of cardiac arrest, but its use in organ donors contradicts current transplantation protocols that specify that donor cadavers should be kept at normal body temperature.
Dr Claus Niemann, Professor of Anesthesia and Surgery at the University of California, San Francisco, San Francisco, California, USA, and colleagues conducted a randomised controlled trial including 370 deceased organ donors, 190 of which were kept at normal body temperature (BT group) and 180 which were kept at approximately 2°C lower than normal body temperature (hypothermia group). A total of 572 patients received kidney transplants from the donors in the study: 287 from the BT group and 285 from the hypothermia group. The results of the study showed that 112 patients (39%) who received transplants from the BT group developed delayed graft function, compared with only 79 patients (28%) who received transplants from the hypothermia group.
“From these findings, potentially more organs could be available for transplantation since we can push the limits with these ‘marginal donors’,” said Dr Niemann. “This is critical because the number of available deceased organ donors has been stagnant, but the demand has dramatically increased. In the United States alone, about 101,000 patients wait for kidney transplantation.”