2013 - ISODP 2013 Congress

Oral Presentation 5 on DCD Programs 2

12.2 - One OPO's 17 Year Experience with Uncontrolled DCD Donors

Presenter: Richard D., Hasz, Philadelphia, United States
Authors: Richard D. Hasz, Howard M. Nathan, John D. Abrams, Sharon M. West, Michael J. Moritz, MD

One OPO's 17 Year Experience with Uncontrolled DCD Donors

Richard D. Hasz1, Howard M. Nathan1, John D. Abrams1, Sharon M. West1, Michael J. Moritz, MD1

1Gift of Life Donor Program, Philadelphia, PA, United States

Aim: To show that uncontrolled DCD organ donation can lead to successful retrieval of tx organs & to evaluate kidney & liver tx outcomes for recipients of organs from uncontrolled donors

Methods: Single OPO, multi-center retrospective study evaluating the procurement and utilization of organs from uncontrolled DCD donors. Graft survival was evaluated using the Kaplan-Meir method.

Results: Between 1996 and 2012, 290 kidneys, 33 livers & 3 pancreata were recovered for tx from 148 uncontrolled DCD donors resulting in the tx of 198 kidneys, 12 livers, and 2 pancreata. Mean donor age was 31 yrs (r = 05-76). Mean warm ischemic time (WIT) of 66 mins (r = 9-214) for the 74 Maastricht Category (MC) II donors was significantly higher than the mean WIT of 45 mins (r = 2-177) for the 74 brain dead donors recovered subsequent to unexpected arrest (MC IV). Kidney utilization rate was 65% for MC II donors and was 72% for MC IV donors and the liver utilization rate was 58% for MC II donors and 24% for MC IV donors. The ATN rate for kidney recipients was not significantly different between the 2 categories (53% ATN rate for MC II & a 56% ATN for MC IV). Kidney graft survival for MC IV was 86% at 6 mos, 80% at 1 yr, 72% at 3 yrs and 61% at 5 yrs. Kidney graft survival for MC II was 80% at 6 mos, 74% at 1 yr, 65% at 3 yrs and 59% at 5 yrs. Of the 7 livers txd from MC II, 6 failed within 60 days of tx and the 7th functioned for 12 years, 7 mos post-tx.  Of the 5 livers txd from MCIV, 3 failed within 65 days of tx and 2 are functioning at 11 yrs and 5 yrs post-tx.

Conclusion: Uncontrolled DCDs provide acceptable kidney graft survival outcomes and represnt a pool of organs that should be pursued for transplantation.  Results from the small number of liver tx are disappointing. 




Figure 1

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