Chen Chuanbao, People's Republic of China
resident doctor
Third Division of Organ Transplant Center
East Campus of First Affiliated Hospital, Sun Yat-sen University
The analysis of discarded kidneys from donors of deceased organ donation
chen chuanbao1, han ming1, wang x ping1, yuan x peng1, zhou jian1, lin j wei1, zhen y tao1, jiao x yuan1, wang c xi2, he x shun1.
1Third division of organ transplant center, East campus of first affiliated hospital, Sun Yat-sen University, guangzhou, People's Republic of China; 2Second division of organ transplant center, First affiliated hospital, Sun Yat-sen University, guangzhou, People's Republic of China
Objective: To analyze the discarded kidneys from donors of deceased organ donation in our center since 2011.
Methods: The data of all donors of deceased organ donation in our center from July 2011 to September 2015 were retrospective analyzed.
Results: There were 223 cases deceased donors during 2011-07 and 2015-09 in our center, 446 kidneys were procured and 46 kidneys were discarded for various reasons. The discard rate of kidney was 9.1% with exclusion of 3 uremic donors. There were 25 donors with discarded kidney, including 20 males and 5 females; the mean age was 38.0 ± 12.4 yrs (16-67yrs). Single kidney was discarded in 4 donors and both kidneys were discarded in 21 donors. The mean level of terminal serum creatine was 398.98±385.5μmol/L (13.41～1633μmol/L) and the mean length of stay in ICU was 17.36±25.36 d (1～126d). According to the Chinese Classification, there were 2 cases of Class I, 18 Class II and 5 Class III. The reasons for discard including donors with acute renal injury (n = 9), it was the main discard reason and occupied 36% in total discard donors. Uremic donors (n = 3), abnormal presentation in macroscopy (n = 3), donors with malignant tumor (n = 2), atheromatous plague in renal artery (n = 2) and others (n = 6). Other reasons contained 2 kidneys were discarded for paraquat poisoning in a donor, renal thrombosis were founded in two donors and discarded 3 kidneys. One donor suffered severe infection before procured and discarded 2 kidneys. The rest two donors both discarded right kidney, one for renal vein injury and the other was renal infarct. Because of the deficiency of clinical experience at the early stage of our organ donation program, there was a high discard rate of acute renal injury donor. Twenty kidneys from 10 donors were discarded from July 2011 to December 2012, 7 of them were discarded for acute renal injury and occupied 77.78% in all discarded cases of acute renal injury.
Conclusion: The main reason for kidney discard was acute renal injury at the early stage of our organ donation program.
Keywords: deceased organ donation; kidney discard; acute kidney injury; kidney transplantation
References:
[1] Huang, J；Wang, H；Fan, S T；et al. The national program for deceased organ donation in China. Transplantation, 2013. 96(1): p. 5-9.
[2] Reese, P.P；Harhay, M N；Abt, P L; et al. New Solutions to Reduce Discard of Kidneys Donated for Transplantation. J Am Soc Nephrol, 2015.
[3] Lee, M. H; Jeong, E. G; Chang, J. Y;et al. Clinical outcome of kidney transplantation from deceased donors with acute kidney injury by Acute Kidney Injury Network criteria. J Crit Care, 2014. 29(3): p. 432-7.
[4] Hall, I. E; Schroppel, B; Doshi, M. D; et al. Associations of deceased donor kidney injury with kidney discard and function after transplantation. Am J Transplant, 2015. 15(6): p. 1623-31.
[5] Heilman, R. L; Smith, M. L; Kurian, S. M.R.L; et al. Transplanting Kidneys from Deceased Donors With Severe Acute Kidney Injury. Am J Transplant, 2015. 15(8): p. 2143-51.
Lectures by Chen Chuanbao
| When | Session | Talk Title | Room |
|---|---|---|---|
|
Sat-20 17:00 - 18:30 |
Kidney Posters | Kidney transplantation from pediatric donors of deceased organ donation | Hall 5FG-Level 5 |
|
Sat-20 17:00 - 18:30 |
Kidney Posters | The analysis of discarded kidneys from donors of deceased organ donation | Hall 5FG-Level 5 |