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Kidney donors after circulatory death (DCD) – single centre experience


Authors: V. Třeška;  T. Reischig;  D. Hasman;  B. Čertík;  J. Moláček;  R. Šulc;  M. Čechura;  L. Kielberger;  K. Houdek;  V. Opatrný
Authors place of work: Transplantační centrum LF Univerzity Karlovy a FN v Plzni přednosta: prof. MUDr. V. Třeška, DrSc.
Published in the journal: Rozhl. Chir., 2016, roč. 95, č. 4, s. 147-150.
Category: Původní práce

Summary

Introduction:
Kidney procurement from donors after circulatory death (DCD) is an important part of worldwide transplantation programmes. The first kidney transplantation from DCD was successfully performed in the Czech Republic in 2002.

Method:
Forty four kidneys from DCD were procured in the Transplant Centre of Pilsen between 2002 and 2015. We used the technique of “in situ“ procurement with the double balloon triple lumen catheter and 5−10 minutes of the no-touch interval. The method of pulsatile hypothermic perfusion was used to test the viability of the kidneys. Twenty eight recipients with mean age 51.1 (26−73) years were transplanted. Sixteen (57.1%) kidneys were from the 2nd, 8 (28.6%) from the 3rd and 4 (14.3%) from the 4th category according to the Maastricht criteria.

Results:
30-day mortality and morbidity rates were 0 and 10.7% i. e.14.3% respectively (N=4). Primary non-function was presented in 2 (7.1%), and delayed graft function in 5 (17.9%) cases. One, five and ten years of recipient and graft survival rates were 100%, 86.4% and 76.7%; and 92.9%, 69.6% and 61.9%, respectively. The long-term results are fully comparable with kidneys transplanted from donors after brain death.

Conclusion:
DCD are an important source for kidney transplantation. Kidney transplantation from DCD is a logistically, economically and personally demanding method with very good long-term results.

Key words:
donors after circulatory death – kidney transplantation – results


Zdroje

1. Třeška V, Hasman D, Čechura M, et al. Naše první zkušenosti s transplantacemi ledvin z dárců s nebijícím srdcem. Rozhl Chir 2002;81:582−6.

2. Třeška V, Hasman D, Hes O, et al. Dárce s nebijícím srdcem – nová možnost rozšíření dárcovského programu ledvin. Rozhl Chir 2000;79:613–8.

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Chirurgie všeobecná Ortopedie Urgentní medicína

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