title: A case of kidney transplantation using donation after circulatory death with renal calculi.
abstract: Donation after circulatory death (DCD) supplies a big percentage of the organ source pool. Compared to living-related donations, donor kidneys from DCD are commonly with lower quality since they inevitably suffer from hypoxia, hypotension, and inadequate organ perfusion during the progression to circulatory arrest. The current case presents a 44-year-old male donor with wide range subarachnoid hemorrhage and multiple skull fracture from a car accident. Multiple stones were detected in his right kidney. We performed a modified ex vivo pyelolithotomy and ureteroscopy on the bench to render a stone-free allograft. We also improved the donor kidney with hypothermic/perfusion preservation machine before renal transplantation. The recipient showed no complications during the first two-month post-operational follow-up. Such a donor kidney with stones may probably be discarded by conventional perspective. Yet, the combination of the ex vivo bench-surgery technique and hypothermic oxygenation/perfusion makes it a qualified donor kidney. Thus we have demonstrated a promising way of saving borderline qualified DCD donor kidneys.
authors.affiliation: Department of Urology/Transplant Center, First Hospital of Jilin University Changchun, China.
authors.forename: Baoshan
authors.initials: B
authors.lastname: Gao
authors.affiliation: Department of Urology/Transplant Center, First Hospital of Jilin University Changchun, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Radiology, First Hospital of Jilin University Changchun, China.
authors.forename: Chunjie
authors.initials: C
authors.lastname: Guo
authors.affiliation: Department of Urology/Transplant Center, First Hospital of Jilin University Changchun, China.
authors.forename: Weigang
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Urology/Transplant Center, First Hospital of Jilin University Changchun, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Urology/Transplant Center, First Hospital of Jilin University Changchun, China.
authors.forename: Yuantao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Urology/Transplant Center, First Hospital of Jilin University Changchun, China.
authors.forename: Liyu
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Urology/Transplant Center, First Hospital of Jilin University Changchun, China.
authors.forename: Yaowen
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Urology/Transplant Center, First Hospital of Jilin University Changchun, China.
authors.forename: Honglan
authors.initials: H
authors.lastname: Zhou
keywords: Donation after circulatory death; kidney transplantation; pyelolithotomy; renal calculi; ureteroscopy