J Korean Med Sci.  2012 Feb;27(2):115-119. 10.3346/jkms.2012.27.2.115.

Kidney Transplantation from a Donor Following Cardiac Death Supported with Extracorporeal Membrane Oxygenation

Affiliations
  • 1Department of Surgery, Ajou University, School of Medicine, Suwon, Korea. ohck@ajou.ac.kr
  • 2Department of Thoracic and Cardiovascular Surgery, Ajou University, School of Medicine, Suwon, Korea.
  • 3Department of Pathology, Ajou University, School of Medicine, Suwon, Korea.

Abstract

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 m2 and 78 mL/min/1.73 m2 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 m2 and 64 mL/min/1.73 m2 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.

Keyword

Extracorporeal Membrane Oxygenation; Kidney Transplantation; Organ Donation After Cardiac Death

MeSH Terms

Adult
*Death
*Extracorporeal Membrane Oxygenation
Female
Glomerular Filtration Rate
Glucose/chemistry
Humans
*Kidney Transplantation
Male
Mannitol/chemistry
Middle Aged
*Organ Preservation
Potassium Chloride/chemistry
Procaine/chemistry
Retrospective Studies
Time Factors
Tissue Donors
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