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Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol
Published on: February 21, 2016
Transplantation of kidneys from deceased adult polycystic donors
J D Olsburgh1, H C Godbole, P J O'Donnell
1Department of Urology, Guy's & St. Thomas' NHS Foundation Trust & GKT School of Medicine, London SE1 9RT, UK.
Abstract:
Renal transplantation is the best treatment for end-stage renal disease. The discrepancy between donor organ supply and demand continues to widen. Maximum efforts should be made to make use of donor kidneys and we suggest that polycystic kidneys can be suitable marginal donor organs. Five polycystic cadaveric donor kidneys were transplanted in four recipients at our institution between year 2000 and 2004. The donor kidneys were either of normal size or moderately enlarged (less than 15 x 10 cm). Donor ages were 24, 46 and 55 years. All donors had normal serum creatinine at the time of organ retrieval. Recipients gave informed consent to be transplanted with the polycystic kidneys. Three of four recipients had primary graft function. The patient with primary nonfunction required graft nephrectomy 8 weeks post-transplantation. One patient died due to cardiovascular causes with a functioning graft 18 months after transplantation. Two patients remain well, 26 and 58 months after transplantation, with normal graft function. Our experience and the limited evidence from the literature suggest that, with careful selection of both donor and recipient, transplantation of cadaveric polycystic donor kidneys should be considered given the current organ shortage.
Insights
Polycystic kidneys from deceased donors can be suitable for transplantation, offering a viable option to address the organ shortage. Careful donor and recipient selection is crucial for successful outcomes in renal replacement therapy.
Area of Science:
- Nephrology
- Transplantation Surgery
Background:
- End-stage renal disease (ESRD) necessitates renal transplantation as the optimal treatment.
- A significant gap exists between the demand for donor organs and their availability, highlighting the need for expanded donor criteria.
Purpose of the Study:
- To evaluate the feasibility and outcomes of transplanting polycystic kidneys from deceased donors.
- To determine if polycystic kidneys can serve as viable marginal donor organs to mitigate organ scarcity.
Main Methods:
- Retrospective analysis of five polycystic kidney transplants performed between 2000 and 2004.
- Inclusion of donor kidneys that were normal or moderately enlarged (<15 x 10 cm) with normal pre-retrieval serum creatinine.
- Recipient informed consent was obtained for transplantation with polycystic kidneys.
Main Results:
- Three out of four recipients achieved primary graft function.
- One patient experienced primary nonfunction requiring graft nephrectomy.
- One patient died with a functioning graft due to cardiovascular causes at 18 months post-transplant.
- Two patients maintained normal graft function at 26 and 58 months post-transplant.
Conclusions:
- Transplantation of carefully selected polycystic donor kidneys is a feasible option for patients with ESRD.
- Utilizing marginal donor organs like polycystic kidneys can help address the critical shortage of donor organs.
- Further research and careful patient selection are warranted to optimize outcomes in this area of renal transplantation.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management