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Kidney transplantation from donation after cardiac death donors in China--a single-center experience
1Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. wcx6363@163.com
Insights
Kidney transplants from cardiac death donors (DCD) in China show promising short-term graft survival. While delayed graft function is more common, DCD donation is feasible for expanding the organ donor pool.
Area of Science:
- Nephrology
- Transplantation Surgery
- Organ Donation
Background:
- Donation after cardiac death (DCD) is a potential strategy to increase organ availability for transplantation.
- Limited data exists on the clinical outcomes of DCD kidney transplantation in China.
Purpose of the Study:
- To evaluate the clinical outcomes of kidney transplantation using organs from DCD donors in China.
- To assess the feasibility of expanding the organ donor pool through DCD donation.
Main Methods:
- Retrospective study of clinical data from 31 DCD donors and 46 DCD kidneys.
- Follow-up of recipients for patient and graft survival.
Main Results:
- 10.3% of DCD donors and 16.7% of kidneys were discarded due to issues like renal thrombosis.
- Successful engraftment in 39 recipients with a mean follow-up of 16 months.
- Delayed graft function (DGF) observed in 38.5% of recipients, with most recovering within 3 months.
- Graft survival rates of 97.4% at 12 months and 94.9% at 24 months.
- Low incidence of acute rejection (5.1%) and all patients survived.
Conclusions:
- Kidney transplantation from DCD donors yields favorable short-term clinical outcomes, including good graft survival and function.
- Despite a higher rate of DGF, DCD donation is a viable method to expand the organ donor pool in China.
Objective:
To report clinical outcomes of kidney transplantation from cardiac death donors (DCD) in China, and to investigate its feasibility to expand the organ donor pool.
Patients And Methods:
We retrospectively studied clinical data of 46 DCD kidneys from 31 donors from February 2007 to August 2011. Recipients were followed for patient and graft survival.
Results:
We discarded the organs from 3 of 29 (10.3%) DCD donors and 7 of 42 (16.7%) kidneys that displayed renal thrombosis. Of the 39 recipients engrafted with DCD kidneys successfully, the mean follow-up was 16 months, (range = 50 days to 43 months). Delayed graft function (DGF) occurred in 15 (38.5%) recipients, who except one recovered within 3 months. Three biopsy-proven acute rejection episodes were observed in two recipients (5.1%). All patients survived through the follow-up. The graft survival rate was 97.4% at 12 months and 94.9% at 24 months. A 45-year-old male recipient who received a pair of grafts from a 6-year-old child survived with good renal function.
Conclusion:
Although kidney transplantations from DCD donors showed a higher rate of DGF with a longer duration of graft recovery, we achieved favorable short-term clinical outcome in terms of graft survival and function. Donation after cardiac death can expand the organ donor pool in China.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure