Kidney transplantation from a donor following cardiac death supported with extracorporeal membrane oxygenation.
To expand the donor pool, organ donation after cardiac death (DCD) has emerged. However, kidneys from DCD donors have a period of long warm ischemia between cardiac arrest and the harvesting of the organs. Recently, we used extracorporeal membrane oxygenation (ECMO) to minimize ischemic injury during 'no touch' periods in a Maastricht category II DCD donor and performed two successful kidney transplantations. The kidneys were procured from a 49-yr-old male donor. The warm ischemia time was 31 min, and the time of maintained circulation using ECMO was 7 hr 55 min. The cold ischemia time was 9 hr 15 min. The kidneys were transplanted into two recipients and functioned immediately after reperfusion. The grafts showed excellent function at one and three months post-transplantation; serum creatinine (SCr) levels were 1.0 mg/dL and 0.8 mg/dL and the estimated glomerular filtration rates (eGFR) were 63 mL/min/1.73 m(2) and 78 mL/min/1.73 m(2) in the first recipient, and SCr levels were 1.1 mg/dL and 1.0 mg/dL and eGFR were 56 mL/min/1.73 m(2) and 64 mL/min/1.73 m(2) in the second recipient. In conclusion, it is suggested that kidney transplantation from a category II DCD donor assisted by ECMO is a reasonable modality for expanding donor pool.
Department of Surgery, Ajou University, School of Medicine, Suwon, Korea.
Jong Hoon
JH
Lee
Sung Yeon
SY
Hong
Chang-Kwon
CK
Oh
You Sun
YS
Hong
Hyunee
H
Yim
D000328:Adult; D003643:Death; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005919:Glomerular Filtration Rate; D005947:Glucose / Q000737:chemistry; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008353:Mannitol / Q000737:chemistry; D008875:Middle Aged; D009926:Organ Preservation; D011189:Potassium Chloride / Q000737:chemistry; D011343:Procaine / Q000737:chemistry; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors
C039984:Bretschneider cardioplegic solution; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose