Paragonix Technology Enables Successful Kidney Transplant After 46 Hours of Ischemia

Paragonix Technologies has achieved a remarkable milestone in organ preservation with its KidneyVault Portable Renal Perfusion System. At the Tampa General Hospital Transplant Institute, a donor kidney underwent continuous hypothermic machine perfusion for over 30 hours, ultimately leading to a successful transplant after a total cold ischemic time (CIT) exceeding 46 hours. This case marks a significant advancement in addressing traditional constraints associated with organ donation and transplantation.

The donor kidney was initially accepted by a transplant center but was later declined due to scheduling challenges. This situation typically leads to the organ being exhausted on the national donor list, which often results in its discard. In a final effort to honour the donor’s wishes, the local organ procurement organisation (OPO) reached out to alternative centres, highlighting the advantages of using the KidneyVault system for continuous perfusion.

After this intervention, the kidney was accepted for transplantation by Dr. Chloe Wang, an Abdominal Transplant Surgeon at the Tampa General Hospital. Following a 2,058 nautical mile direct flight via commercial air travel, the organ was successfully transplanted, and the patient was later released without complications, avoiding delayed graft function.

Advancements in Preservation Technology

Typically, donor kidneys are preserved using hypothermic methods, relying on either ice or machine perfusion, and are transplanted within 24 hours of cooling. A 2022 study indicated that over 80% of donor kidneys meet these criteria. However, extending CIT beyond 36 hours is rare, with only 1.8% of transplantations reported after more than 40 hours. Such extended ischemic times increase the risk of delayed graft function and long-term complications, highlighting the critical need for advanced preservation techniques.

The KidneyVault system represents a significant leap from traditional static cold storage. By continuously circulating preservation solution through the organ, it reduces cellular injury and helps mitigate ischemia-reperfusion injury. Cleared by the FDA in October 2024, this system is designed for continuous, end-to-end hypothermic perfusion while offering integrated real-time remote monitoring.

Addressing Organ Shortages

The portable design of the KidneyVault system allows for logistical flexibility, maintaining consistent preservation conditions even over extended periods. With kidney transplant candidates making up approximately 86% of the national transplant waitlist—nearly 90,000 individuals in 2024—the demand for effective organ utilisation strategies is critical. Technologies like the KidneyVault system play a key role in increasing transplant opportunities, especially for marginal or logistically complex donor organs.

Dr. Kiran Dhanireddy, Vice President and Chief of the Tampa General Hospital Transplant Institute, emphasized the institution’s commitment to leveraging technology for patient benefit. He stated, “Our collaboration with Paragonix across all solid organ programs enables us to evaluate and utilise donor organs from greater distances and with increased medical complexity. Advanced preservation technologies directly support our shared mission to increase access and maximise transplant opportunities.”

The successful application of the KidneyVault system in this case underscores the potential of innovative technologies to enhance organ preservation and improve patient outcomes in transplantation.