Contribution of Donors After Cardiac Death to the Deceased Donor Pool: 2002 to 2009 University of Liege Experience

Ledinh, Hieu; Meurisse, Nicolas; Delbouille, Marie‐Hélène; Monard, Josée; Hans, Marie-France; Bonvoisin, Catherine; Weekers, Laurent; Joris, Jean; Kaba, Abdourahmane; Lauwick, Séverine; Damas, Pierre; Damas, François; Lambermont, Bernard; Kohnen, Laurent; Deroover, Arnaud; Honoré, Pierre; Squifflet, Jean‐Paul; Meurisse, Michel; Detry, Olivier

doi:10.1016/j.transproceed.2010.07.018

Cited by 15 publications

(14 citation statements)

References 26 publications

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“…In contrast, European centers consistently report higher rates of DCDD utilization of up to 30-70% of all deceased donors, including some uncontrolled (Maastricht type 2) donors [3 ,4 , [5][6][7]. Ledinh et al [8 ] report the recent development of a DCDD program in Belgium over 8 years. The number of DCDD grafts increased from 3.7% of all liver and kidney grafts in 2002 to 34% in 2009 with nearly a quarter of all kidney transplants from donors after circulatory determination of death [8 ].…”

Section: Introductionmentioning

confidence: 99%

Utilization of kidneys from donation after circulatory determination of death

Evenson

2011

Current Opinion in Organ Transplantation

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DCDD kidneys continue to demonstrate increased rates of delayed graft function and primary nonfunction when compared with kidneys recovered after donation after brain death (DBD) likely due to increased warm ischemic time during recovery. Despite early complications, DCDD kidneys show comparable function and survival after the immediate postoperative period and have been demonstrated to provide a survival benefit to recipients over waiting for DBD kidneys. The effect of machine perfusion on DCDD kidneys may decrease delayed graft function but has no effect on long-term function. Despite concerns, the increasing number of DCDD donors does not appear to be directly responsible for decreased numbers of DBD donors.

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Section: Introductionmentioning

confidence: 99%

Utilization of kidneys from donation after circulatory determination of death

Evenson

2011

Current Opinion in Organ Transplantation

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“…Since its implementation four and a half years ago, DCD has accounted for 10.9% of deceased donor activity in Ontario, Canada [18] . The majority of DCD kidneys are from controlled donors meaning that the number of organs can be further increased by utilising uncontrolled donors [3,4,12,[19][20][21][22][23][24][25][26][27][28][29][30] although the associated workload is considerably more and the yield rate poorer. Reports from some centres show that DCD from deaths outside the hospital may be a good source of donor kidneys and may provide a way to successfully increase the donor pool for organ transplantation [31] .…”

Section: Spread Of Practicementioning

confidence: 99%

“…Koffman [72] showed that DCD consistently increased the number of available kidneys without any effect on DBD donations. Ledinh et al [26] evaluated the organ procurement and transplantation activity from DCD in their unit (Belgium) over an 8-year period to determine its effect on transplantation programs, or DBD activity. They concluded that the establishment of a DCD program enlarged the donor pool and did not compromise the development of DBD program.…”

Section: Series Type Number Patient Survival (%) Graft Survival (%) Dmentioning

confidence: 99%

Kidney donation after cardiac death

Akoh¹

2012

WJN

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There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death (DCD) and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to controlled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function (DGF) and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that significantly influences the outcome of allografts, for example, limiting it to < 12 h markedly reduces DGF. DCD kidneys from donors < 50 function like standard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled donation, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kidneys from DCD include: implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function.

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“…In brief, the study demonstrated that 1 year kidney graft survival was 12% higher in recipient of a machine perfused graft which presented a PO delayed graft function (DGF) compared to recipients of a cold storage preserved graft. 27 . That study helped the Belgian Centers to implement the use of DCD without jeopardizing the DBD procurement rate (Fig.…”

Section: As In Hbd Procedures the Diagnosis Of Death In A Nhbd Has Tmentioning

confidence: 99%

The History of Kidney Transplantation: Past, Present and Future (with Special References to the Belgian History)

Jp¹

2011

Understanding the Complexities of Kidney Transplantation

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Contribution of Donors After Cardiac Death to the Deceased Donor Pool: 2002 to 2009 University of Liege Experience

Cited by 15 publications

References 26 publications

Utilization of kidneys from donation after circulatory determination of death

Utilization of kidneys from donation after circulatory determination of death

Kidney donation after cardiac death

The History of Kidney Transplantation: Past, Present and Future (with Special References to the Belgian History)

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