Factors Associated With Discard of Recovered Kidneys

Cho, Y.W.; Shah, Tariq; Cho, E.S.; Stadtler, Maria; Simmons, Vaughan P.; Mone, Thomas; Méndez, R.; Hutchinson, I. V.; Gill, Jagbir; Bunnapradist, Suphamai

doi:10.1016/j.transproceed.2008.03.061

Cited by 12 publications

(9 citation statements)

References 7 publications

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“…However, evaluation of the organ post-storage and prior to transplantation remains subjective, with assessment generally limited to gross morphology and donor criteria [5]. Histology is performed occasionally, although reports in kidney transplantation indicate its use does not significantly increase the likelihood of graft survival[6–8]. Even machine perfusion has yet to provide definitive quantitative criteria of organ viability, despite the availability of multiple dynamic measurements [9].…”

Section: Introductionmentioning

confidence: 99%

Hepatocyte Viability and Adenosine Triphosphate Content Decrease Linearly Over Time During Conventional Cold Storage of Rat Liver Grafts

Berendsen

Izamis

et al. 2011

Transplantation Proceedings

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Introduction The gold standard in organ preservation is static cold storage (SCS) using University of Wisconsin solution (UW). While it’s known that there is a finite limit to SCS preservation, and that there is a correlation between the ATP levels and organ function post preservation, a quantitative relationship has not been established, which is important in understanding the fundamental limitations to preservation, minimizing cold ischemic injury and hence maximizing utilization of the donor organ pool. Aim To determine the time limits of cellular viability and metabolic function during SCS, and to characterize the relationship between cellular viability and energetic state, using clinically relevant techniques in organ preservation. Methods Rat livers were procured and stored using conventional storage in UW solution at 4°C. Viability was assessed by determining the amount of viable hepatocytes and intracellular ATP content after 0, 24, 48, 72 and 120 hours of storage. Results Numbers of viable hepatocytes that were isolated from these livers decreased steadily during SCS. After 5 days, viable hepatocytes decreased from 25.95×106 to 0.87×106 cells/gram tissue. Intracellular ATP content decreased from 9.63 to 0.93 μmoles/gram tissue. Statistical analysis (ANOVA) established a linear relation for both parameters as a function of time (P<0.05). Conclusion The linear correlation between hepatocyte viability, ATP content, and storage time suggests a shared physiological foundation. These findings confirm ATP as direct predictor for organ quality in the context of liver preservation, which will aid quantitative assessment of donor organs for various applications.

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Section: Introductionmentioning

confidence: 99%

Hepatocyte Viability and Adenosine Triphosphate Content Decrease Linearly Over Time During Conventional Cold Storage of Rat Liver Grafts

Berendsen

Izamis

et al. 2011

Transplantation Proceedings

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“…Given the scarcity of donor kidneys, we should maximize their use. Studies have shown that despite best efforts, patients who could benefit from ECD kidneys are still not being listed (14), and a disproportionate number of recovered organs are still being wasted (24). On the other hand, we have to make certain that such kidneys are being allocated to individuals who are most likely to benefit and not disproportionately allocated to minorities with low socioeconomic and educational status.…”

Section: Discussionmentioning

confidence: 99%

Racial and Socioeconomic Disparities in the Allocation of Expanded Criteria Donor Kidneys

Mohandas

Casey

Cook

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives In carefully selected individuals, receiving expanded criteria donor (ECD) kidneys confer a survival advantage over remaining on dialysis. However, wait lists for ECD kidneys often include a significant proportion of young patients, who have no predictable survival benefit from ECD kidneys. This study hypothesized that educational and socioeconomic factors might influence a younger patient's decision to accept an ECD kidney.Design, setting, participants, & measurements This study was a retrospective analysis of all first single-kidney transplants in the Scientific Registry of Transplant Recipients database from 2000 to 2009 in patients aged 18-40 years and waitlisted ,3 years. The primary outcome measured was the odds of receiving an ECD kidney compared with an standard criteria donor kidney in different demographic subgroups. Race, income, and education were analyzed in main-effect and two-way interaction models, corrected for candidate panel reactive antibodies and sex.Results Of 13,615 ECD transplants, 591 kidneys (4.3%) went to recipients aged between 18 and 40 years who were waitlisted ,3 years. African Americans (odds ratio, 1.71; 95% confidence interval, 1.26 to 2.33) or those with low education (odds ratio, 2.32; 95% confidence interval, 1.38 to 3.89) were more likely to receive an ECD kidney than Caucasians or those with a college degree, respectively. However, African Americans with higher education levels did not have significantly higher odds of receiving an ECD kidney than Caucasians with a college degree.Conclusions In patients aged ,40 years and waitlisted ,3 years, African Americans and those with lower educational status and low income are more likely to receive an ECD kidney than Caucasians or those with higher education. It is important that health care providers and patients understand such disparities to facilitate a more rational use of ECD kidneys.

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“…According to reports, the alarming rate of discard of recovered organs is mostly because of the increase in the number of donors older than 50, who now represent over 30% of the national donor population. [9] It is well described that the incidence of simple cysts increases with age, with a 25%-40% incidence in 50 year olds. [10] The size of cysts varies with age, with larger cysts found in the older population.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of renal transplantation after unroofing of a large renal cyst in an expanded criteria donor

Kanagarajah¹,

Ekwenna

Ayyathurai³

et al. 2013

Urol Ann

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We present a case in which a deceased donor kidney with a large simple cyst was successfully unroofed and transplanted to a 61-year-old male. The donor was a 62-year-old male with a history of hypertension for 2 years; cerebral vascular accident was the cause of death. A large 8-cm cyst distorting the renal hilum was identified upon the procurement of the deceased donor kidney. Prior to transplantation, the large cyst was unroofed from the allograft; the frozen section confirmed a benign cyst and the transplant was performed. Postoperatively, the serum creatinine level was 1.4 mg/ml at 22-month follow-up and the patient was normotensive. Deceased donor kidneys with giant cysts distorting the renal hilum can be effectively transplanted.

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Factors Associated With Discard of Recovered Kidneys

Cited by 12 publications

References 7 publications

Hepatocyte Viability and Adenosine Triphosphate Content Decrease Linearly Over Time During Conventional Cold Storage of Rat Liver Grafts

Hepatocyte Viability and Adenosine Triphosphate Content Decrease Linearly Over Time During Conventional Cold Storage of Rat Liver Grafts

Racial and Socioeconomic Disparities in the Allocation of Expanded Criteria Donor Kidneys

Feasibility of renal transplantation after unroofing of a large renal cyst in an expanded criteria donor

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