title: Pursuing expanded criteria donors as candidates for kidney donation after circulatory death.
abstract: Of the 119 310 people on the national transplant waiting list, 97 280 people are waiting for kidneys. There simply are not enough organs to meet the demand. Recognizing that 64% of the people waiting for kidney transplants are at least 50 years old, this organ procurement organization embarked on a study to evaluate the potential of increasing the number of viable kidneys available for transplant by pursuing expanded criteria donors as donation after circulatory death (ECD/DCD) candidates. Pursuing ECD/DCD donors resulted in 24 additional donors (50-67 years old), 48 kidneys recovered, 30 kidneys transplanted into 26 recipients (44-74 years old), 7 kidneys placed for research, and 11 kidneys discarded, yielding an overall 62% transplant rate, 15% research rate, and 23% discard rate. The overall discard rate including all donors in all classifications during the study period was 13.1% (122 discards from 928 kidneys) compared with 12.6% (111 discards from 880 kidneys) when the study set was excluded. Although ECD/DCD donors still had the highest discard rates of all the groups, the 0.5% increase in the overall discard rate due to pursuing ECD/DCD kidneys was considered insignificant when compared with the benefit of the 30 additional kidneys transplanted. Including potential ECD/DCD patients in the donor pool increases the number of viable kidneys available for transplant without significantly increasing the overall kidney discard rates.
authors.affiliation: Carolina Donor Services, Durham, North Carolina.
authors.forename: Ginger T
authors.initials: GT
authors.lastname: DeLario
authors.affiliation: Carolina Donor Services, Durham, North Carolina.
authors.forename: Jim
authors.initials: J
authors.lastname: Quetschenbach
authors.affiliation: Carolina Donor Services, Durham, North Carolina.
authors.forename: Donna
authors.initials: D
authors.lastname: Croezen
authors.affiliation: Carolina Donor Services, Durham, North Carolina.
authors.forename: Danielle
authors.initials: D
authors.lastname: Niedfeldt
authors.affiliation: Carolina Donor Services, Durham, North Carolina.
authors.forename: Julie
authors.initials: J
authors.lastname: Landon
mesh_terms: D000328:Adult; D000368:Aged; D003643:Death; D046148:Donor Selection; D006085:Graft Survival; D006801:Humans; D007668:Kidney; D008875:Middle Aged; D009926:Organ Preservation; D009927:Tissue and Organ Procurement