Use of DCD organs: Expanding the donor pool to increase pediatric transplantation

Area of Science:

• Pediatric Transplantation
• Organ Donation and Transplantation
• Nephrology and Hepatology

Background:

• A persistent gap exists between the number of children awaiting transplants and the availability of donor organs.
• Transplant rates for pediatric liver and kidney recipients have remained stagnant over the last decade.
• Donation after circulatory death (DCD) presents a potential strategy to address organ scarcity in transplantation.

Purpose of the Study:

• To review the current literature on the utilization of DCD donor organs in pediatric liver and kidney transplantation.
• To evaluate the outcomes of pediatric transplants utilizing DCD-derived allografts.
• To assess the viability of DCD organs as a method to increase organ availability for pediatric recipients.

Main Methods:

• Systematic literature review of studies reporting on pediatric liver and kidney transplantation using DCD donors.
• Analysis of organ utilization rates and patient/allograft survival data.
• Comparison of outcomes between DCD and donation after brain death (DBD) donor organs in pediatric recipients.

Main Results:

• The utilization of DCD organs in pediatric transplantation is currently limited but shows potential for growth.
• Pediatric transplants performed with carefully selected DCD liver and kidney allografts demonstrate outcomes comparable to those from DBD donors.
• Evidence suggests that DCD organs can achieve similar success rates to DBD organs in pediatric recipients.

Conclusions:

• DCD donation represents a viable strategy to mitigate organ scarcity in pediatric transplantation.
• Careful selection and utilization of DCD organs can lead to successful pediatric liver and kidney transplant outcomes.
• Increased use of DCD organs could significantly improve organ availability for children in need of transplantation.