For the first time in Australia, Westmead Hospital clinicians with the support of Westmead Institute for Medical Research (WIMR) researchers have performed a successful transplant of a ‘revived’ kidney – a cutting-edge approach that could allow many more kidney transplants to be performed.
Auburn resident Folio Emelio, 64, was the first of two patients to receive one of the specially-treated donor kidneys in November 2020, ending nearly seven years of dialysis for 15 hours every week.
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“I really appreciate what the doctors have done for me,” Mr Emelio said.
“I feel great. Everything is going well. I am so grateful to all the doctors and the Australian Government for supporting this research.
“This is an opportunity for me to enjoy freedom from dialysis and to help the researchers, and hopefully help more people in the future.”
If the good results seen so far are maintained, the procedure could help to increase the number of viable kidneys available for transplant.
It would also improve kidney function immediately after surgery, and mean kidneys could be safely stored for longer, reducing the need for after-hours surgeries.
Mr Emelio, a father of seven, was the first patient in Australia to receive a kidney that was ‘resuscitated’ with a process known as normothermic machine perfusion (NMP) to reverse any damage caused during low-temperature storage.
NMP is a process that supplies the damaged organ with red blood cells, body temperature and oxygen, effectively ‘resuscitating’ kidney cells damaged by exposure to cold or other injury and improving function of the donated organ.
Organs from deceased donors need to be stored on ice during transport, and while every care is taken in this process, some retrieved kidneys are not able to be used due to damage caused by exposure to cold.
The non-utilisation rate of donor kidneys is also much higher overseas, meaning this research could have significant benefits globally.
The results of the first two transplants of a kidney treated with NMP are very promising. At 12 weeks post-surgery, the patients are doing very well and have good kidney function, avoiding the need for post-operative dialysis – which is required in about half of all kidney transplants.
“While the kidney must be preserved in ice, the cold temperature can damage the kidney over many hours. In some instances, the damage can be so severe that the kidney does not work after transplantation,” explains Associate Professor Natasha Rogers, a transplant nephrologist at Westmead Hospital and deputy director of WIMR’s Centre for Transplant and Renal Research.
The NMP research project was carried out by PhD student Dr Ahmer Hameed, supervised by Associate Professor Rogers, Westmead Hospital transplant surgeon Professor Henry Pleass and WIMR transplant research expert Professor Wayne Hawthorne.
“For this pilot stage, we sought to prove the feasibility and safety of the procedure. We were able to access donated kidneys that had been damaged to the point where they could not be transplanted, and we demonstrated in the lab that NMP could resuscitate these kidneys,” Dr Hameed said.
“Not only this, but the NMP technique seemed to improve kidney quality over time, so the kidney worked better and straight away.”
Each year in Australia more than 800 people receive a transplant due to kidney failure caused by injury or disease, such as diabetes and high blood pressure.
Increasing the number of donor kidneys that are suitable for transplantation would have a major impact on kidney transplant wait times in Australia and around the globe.
To find out more about organ and tissue donation, and register to become a donor, visit donatelife.gov.au.
Westmead Hospital is a world-leading site for kidney transplantation, performing an average of 120 transplants each year.
WIMR is a multidisciplinary, translational research hub that brings together some of the brightest minds to deliver real and significant research breakthroughs.
The Westmead Health Precinct is one of the largest health, education, research and training precincts in Australia, home to four major hospitals, four world-leading medical research institutes, two university campuses and the largest research-intensive pathology service in NSW.