Woman celebrates surgical world first that heralds revolution in transplants

Deborah Bakewell, 56, was on dialysis for nine hours every night over a two-year period after suffering kidney failure.

Mrs Bakewell was diagnosed with polycystic kidney disease, a rare, genetic illness that gradually leads to kidney failure, when she was 23.

But the slow onset of symptoms means she did not suffer full-blown renal failure until 2008, by which time she was in her early 50s.

Today experts announced the success of kidney transplants for 17 patients, including Mrs Bakewell, using a relatively new technique called normothermic perfusion.

This involves treating the kidney with warmed oxygenated blood after it has been removed from a donor to avoid the damage normally caused by refrigeration.

The technique also boosts the function of kidneys from “marginal donors”, such as the elderly or people with high blood pressure and diabetes, and cuts the risk of the organ being rejected.

Experts believe normothermic perfusion could increase the success rate of kidney transplants and extend the life of organs, while also boosting the number of organs available from marginal donors by about 500 a year.

All 17 operations, on five men and 12 women, were carried out at a unit at Leicester General Hospital which is the first in the world to introduce the technique to clinical practice.

The operations, involving organs from marginal donors, were performed between November 2010 and November 2011, with the results published for the first time yesterday.

Mrs Bakewell, who has four stepchildren and one of her own, underwent her operation in December 2010.

Her kidney was rejected by six transplant centres, owing to the fact it was damaged, but the team at Leicester had faith their new technique could improve its chance of functioning.

She said: “My mother also suffered from polycystic kidneys and it all caught up with her in in her early 50s, as it did with me.

“My kidney function was about 8% and my organs were not filtering waste properly. I was getting more and more tired and kept getting kidney infections. Sometimes I thought I had terrible backache but it was actually a kidney infection.”

Mrs Bakewell, who lives in Lincoln, was told by Professor Mike Nicholson, based at Leicester, that her kidney was damaged before she underwent the operation.

“I thought: I trust this doctor, I trust his team.

“If they thought it was the right time then I thought: let’s get on with it.”

Mrs Bakewell received her new kidney but her two own damaged kidneys were left in place.

She said: “I feel fantastic now and my kidney function is just amazing. It’s probably quite a lot better than a lot of people my age with two kidneys.

“When I was on dialysis it was for nine hours a night, seven nights a week.

“Now I have my freedom. We have booked our first holiday in years for June, to Majorca.”

Prof Nicholson said: “Normothermic perfusion allows us to gradually reintroduce blood flow to donor kidneys outside of the body and in a controlled way.

“This reverses much of the damage caused by cold storage while offering us a unique opportunity to treat the organs with anti-inflammatory agents and other drugs before going on to complete the transplant procedure.

“In short, we’re able repair and revive damaged kidneys in a way that would otherwise be impossible.”

Only one of the 17 kidneys showed signs of “delayed graft function” after the transplant. All are now functioning well.

Prof Nicholson said: “There’s often great reluctance among health professionals to use kidneys from marginal donors as there’s no way to establish how much damage has been caused to the organs and whether or not they will work.

“As a result, these organs are often discarded as a precaution rather than taking the risk of using them for transplants. Normothermic perfusion allows us to perform a crucial viability check on these kidneys, pumping them with blood to confirm whether or not they function adequately enough to be used for transplantation.”

Kidney Research UK, which funded the project, estimates the new technique could cut the transplant waiting list by more than 10%.

At the moment more than 6,400 kidney patients in the UK need a transplant, out of a total transplant list of almost 7,600 people.

The average cost of keeping a patient on dialysis for one year is £30,800.

A full kidney transplant is a one-off cost of around £42,000 per patient, with maintenance costs of £6,500 per year thereafter.

Charles Kernahan, chief executive of Kidney Research UK, said: “This project represents a major step in the fight against kidney disease. Although transplantation is by no means a cure for kidney failure, it is by far the best treatment method available to us at this time.

“In developing a process that not only maximises the quality of kidneys taken from marginal donors but could also lead to hundreds more transplants being carried out each year, our researchers have given fresh hope to the people in the UK currently waiting for a kidney.”