A simple alteration to kidney preservation solutions could improve transplant outcomes

A team at Lawson Health Research Institute and London Health Sciences Centre (LHSC), has been working to improve organ preservation for kidney transplant patients.

Dr. Alp Sener, Lawson Scientist and LHSC Transplant Surgeon has been studying how to better preserve a donated kidney by altering the preservation solution that is used during transplantation.

“We have been investigating a molecule called hydrogen sulfide for over ten years now. It is something that we all make in our own bodies naturally. The levels of the molecule go up in all living beings when there is stress or lack of oxygen delivered to the tissues,” explains Dr. Sener. “We wondered if adding this molecule to organ preservation solutions would protect organs when they have no oxygen due to being removed from a donor for transplant.”

 

Dr. Alp Sener

By adding hydrogen sulfide molecules to the standard organ preservation solution, the team noticed beneficial effects in preclinical models.  

“In preclinical models of kidney transplantation, we found that adding hydrogen sulfide donor molecules to the preservation solution helped the kidney recover faster and enabled it to start making urine quicker,” adds Dr. Sener.

This discovery led the team to find a surrogate drug already approved for clinical use that has similar properties to hydrogen sulfide donor molecules used in the laboratory. The drug is called sodium thiosulfate. After working to find the proper balance and dose, the team discovered the same beneficial effects in preclinical model transplants with sodium thiosulfate that they did with other experimental hydrogen sulfide donor molecules.

Kidneys in preservation solution

 

With approvals through Health Canada, the research team has embarked on the first ever human trial by using this new preservation solution with ten kidney transplant patients at LHSC. Five patients randomly received a kidney preserved in the altered solution, while five were part of the control group.

“Preliminary analysis of this trial, for quality assurance purposes, showed that the patients who received kidneys with the modified preservation solution produced urine faster, had less dialysis after transplant and spilled less protein into their urine compared to kidneys preserved in the standard preservation solution,” explains Dr. Sener. “There was no difference in the donor type or the time that the kidneys were being preserved; the only difference between these patients was the added drug into the organ preservation solution.”

The research team is still enrolling patients for this pilot study.  They hope to eventually launch a larger, multicenter study across Canada.

“This is very exciting for our patients and care teams. This is a simple alteration that we believe is going to make a great impact,” says Dr. Sener.

He adds that this method isn’t just exclusive to kidney transplants, as his team plans to work with the organ transplant teams at LHSC to examine the same method for both heart and liver transplants in the future.

This pilot study has been made possible by generous donations to London Health Sciences Foundation, as well as, grant money through the Kidney Foundation of Canada and the Academic Medical Organization of Southwestern Ontario (AMOSO). 

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Celine Zadorsky

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Lawson Health Research Institute
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