Related Experiment Video
Updated: Dec 28, 2025
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Kidney transplantation following uncontrolled donation after circulatory death
Dominic M Summers1, Gavin J Pettigrew
1Department of Surgery, University of Cambridge, Cambridge, UK.
Purpose Of Review:
The identification and utilization of kidneys from uncontrolled donation after circulatory death (uDCD) donors for transplantation may increase transplantation rates markedly. This article summarizes the latest international results from successful uDCD kidney transplant programmes and considers how such programmes may impact on the transplant waiting list.
Recent Findings:
The results of more than 1000 uDCD donor kidney transplants have been reported since 2007 from France and Spain. Estimates from France, Spain and Sweden suggest that effective utilization of the potential uDCD donor pool might increase donation rates by 25%. The main concern relating to uDCD kidney transplantation is the high incidence of primary nonfunction with the incidence of primary nonfunction reported as 7-8% even with careful donor selection and the use of normothermic regional perfusion at the time of organ recovery. Notwithstanding, reported 1- year graft survival figures are equivalent to those from expanded criteria donors (ECD) and 10-year graft survival of between 72 and 82% was reported in the two single-centre series with longest reported follow-up period.
Summary:
Uncontrolled DCD kidney transplantation has been successfully implemented in several regions in France and Spain. Wider implementation of uDCD programmes would increase substantially the number of kidneys for transplantation, while maintaining acceptable transplant outcomes.
Insights
Utilizing kidneys from uncontrolled donation after circulatory death (uDCD) donors can significantly boost kidney transplant rates. Despite some primary nonfunction, outcomes remain comparable to expanded criteria donors, offering hope for transplant waiting lists.
Area of Science:
- Nephrology
- Transplantation Surgery
- Organ Donation
Background:
- Kidney transplantation is limited by donor organ availability.
- Donation after circulatory death (DCD) offers a potential source of organs.
- Uncontrolled DCD (uDCD) donation presents an opportunity to expand the donor pool.
Purpose of the Study:
- To review international outcomes of kidney transplantation from uDCD donors.
- To assess the impact of uDCD programs on transplant waiting lists.
- To evaluate the feasibility and results of uDCD kidney transplantation.
Main Methods:
- Review of international data from successful uDCD kidney transplant programs.
- Analysis of reported outcomes, including primary nonfunction rates and graft survival.
- Estimation of the potential increase in donation rates from the uDCD pool.
Main Results:
- Over 1000 uDCD kidney transplants reported since 2007.
- Potential to increase donation rates by 25% through uDCD utilization.
- Primary nonfunction incidence of 7-8%, despite careful selection and perfusion techniques.
- 1-year graft survival comparable to expanded criteria donors (ECD).
- 10-year graft survival reported between 72-82% in long-term follow-up studies.
Conclusions:
- Successful implementation of uDCD kidney transplantation in France and Spain.
- Wider adoption can substantially increase kidney availability for transplantation.
- Acceptable transplant outcomes can be maintained with uDCD programs.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...