Use of suicidal deaths as kidney donors: a single-center experience

Although the number of end-stage renal disease patients on the waiting list has increased, the number of deceased kidney donors has not increased proportionately. Therefore, the use of kidney donors defined as "marginal" has become an issue. Since the acceptance of deaths due to poisoning or suicide as donors has been proposed, we evaluated the clinical courses of kidney transplantations from suicidal death donors.

We analyzed retrospectively the outcomes of nine deceased donor kidneys (8 males) from suicide victims between 2001 and 2012. Demographic and clinical characteristics of donors and recipients were collected from medical files.

The mean donor age was 27.8 ± 11.9 years. Causes of death were: gunshot wounds to the head (n:4), pesticide intoxication (n:2), methanol intoxication (n:1), hanging (n:1), or carotid artery laceration (n:1). Mean donor creatinine level, urine output per hour, and 24-hour urine volume were 0.94 ± 0.53 mg/dL, 270 ± 113 mL, and 5496 ± 832 mL, respectively. Mean cold ischemia time was 12.3 ± 5.7 hours. Primary allograft nonfunction occurred in one recipient requiring nephrectomy. The average posttransplantation creatinine level at 1 year was 1.19 ± 0.62 mg/dL. The mean follow-up was 55 ± 49 months. Allograft loss occurred due to chronic rejection in three patients at 10, 37, and 40 months. Five patients are still undergoing follow-up with functioning grafts.

Brain death cases caused by the suicide should be considered for organ donation.