BACKGROUND: To stimulate organ donation, an organ procurement organization (OPO)-wide effort was undertaken to increase donors after cardiac death (DCD) over a 5-year period. This included commonality of protocols, pulsatile perfusion of kidneys, centralization of data and a regional allocation variance designed to minimize cold ischemia times and encourage adoption of DCD protocols at transplant centers. RESULTS: In one OPO, eight centers initiated DCD programs in 11 hospitals. A total of 52 DCD donors were procured, increasing from four in 1999 to 21 in 2003. Eleven donors had care withdrawn in the operating room, whereas 41 had care withdrawn in the ICU. In all, 91 patients received renal transplants from these 52 donors (12 kidneys discarded, one double transplant), whereas 5 patients received liver transplants. One-, two-, and three-year kidney graft survival rates were 90%, 90%, and 82%, respectively. Fifty-five percent of patients needed at least one session of hemodialysis postoperatively. Mean recipient hospital length of stay was 11.1+/-6 days. Mean creatinine levels at 3, 6, 12, and 24 months were 1.65, 1.40, 1.41, and 1.40, respectively. CONCLUSIONS: DCD donors can be an important source of donor organs and provide excellent overall outcomes. Regional cooperation and a prospectively considered allocation and distribution system are important considerations in stimulating DCD programs.
BACKGROUND: To stimulate organ donation, an organ procurement organization (OPO)-wide effort was undertaken to increase donors after cardiac death (DCD) over a 5-year period. This included commonality of protocols, pulsatile perfusion of kidneys, centralization of data and a regional allocation variance designed to minimize cold ischemia times and encourage adoption of DCD protocols at transplant centers. RESULTS: In one OPO, eight centers initiated DCD programs in 11 hospitals. A total of 52 DCD donors were procured, increasing from four in 1999 to 21 in 2003. Eleven donors had care withdrawn in the operating room, whereas 41 had care withdrawn in the ICU. In all, 91 patients received renal transplants from these 52 donors (12 kidneys discarded, one double transplant), whereas 5 patients received liver transplants. One-, two-, and three-year kidney graft survival rates were 90%, 90%, and 82%, respectively. Fifty-five percent of patients needed at least one session of hemodialysis postoperatively. Mean recipient hospital length of stay was 11.1+/-6 days. Mean creatinine levels at 3, 6, 12, and 24 months were 1.65, 1.40, 1.41, and 1.40, respectively. CONCLUSIONS: DCD donors can be an important source of donor organs and provide excellent overall outcomes. Regional cooperation and a prospectively considered allocation and distribution system are important considerations in stimulating DCD programs.
Authors: Roberto Hernandez-Alejandro; Yves Caumartin; Cameron Chent; Mark A Levstik; Douglas Quan; Norman Muirhead; Andrew A House; Vivian McAlister; Anthony M Jevnikar; Patrick P W Luke; William Wall Journal: Can J Surg Date: 2010-04 Impact factor: 2.089
Authors: J M Smith; S W Biggins; D G Haselby; W R Kim; J Wedd; K Lamb; B Thompson; D L Segev; S Gustafson; R Kandaswamy; P G Stock; A J Matas; C J Samana; E F Sleeman; D Stewart; A Harper; E Edwards; J J Snyder; B L Kasiske; A K Israni Journal: Am J Transplant Date: 2012-11-16 Impact factor: 8.086
Authors: Anton I Skaro; Colleen L Jay; Talia B Baker; Edward Wang; Sarina Pasricha; Vadim Lyuksemburg; John A Martin; Joseph M Feinglass; Luke B Preczewski; Michael M Abecassis Journal: Surgery Date: 2009-10 Impact factor: 3.982
Authors: Zachary Predmore; Brianna Doby; Debra G Bozzi; Christine Durand; Dorry Segev; Jeremy Sugarman; Aaron A R Tobian; Albert W Wu Journal: AIDS Care Date: 2021-06-28