Korean J Transplant.  2022 Nov;36(Supple 1):S213. 10.4285/ATW2022.F-3515.

Uncontrolled donation after circulatory determination of death: 11-years single center experience in India

• Sharma A
• Singh S
• Panjathia A
• Sharma A
• Kenwar DB
• S Patil SK

• KMID: 2535278
• DOI: http://doi.org/10.4285/ATW2022.F-3515

Abstract

Background
Donation after circulatory determination of death (DCDD) donors is now looked upon as potential source of organs with increasing contribution to donor pool world over. Current study aims to analyze the outcomes of uncontrolled DCDD kidneys performed within the confines of restrictive legislative, ethical, and infrastructural challenges in India.
Methods
A single center retrospective study done from February 2011 to January 2022 to analyze outcomes after DCDD. The patient data was retrieved from file records, electronic database and outpatient department follow-up of the department of renal transplant surgery Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Results
From 19 eligible DCDD donors 38 kidneys were retrieved. Thirty-one (81.5%) kidneys were utilized and seven (18.5%) kidneys were discarded (six unfit and one without recipient).The utilized 31 kidneys were allocated to 28 recipients (25 single kidney and three dual kidney recipients) with mean (standard deviation [SD]) age 41 (11.7) years. Donors mean (SD) age was 31 (15) years with majority donors had severe head injury (15/19). Mean (SD) warm ischemia time was 35.04 (11) minutes. Delayed graft function (DGF) and primary non function (PNF) rate was 71.4% and 10.7% respectively. Rejection rate was 14.2%. Entire study period witnessed eight (three PNF and five after initial function) graft losses (28.5%). Serial interval analysis of estimated glomerular filtration rate (eGFR) revealed significant rise (P=0.016) up to 1 year after transplant with fall in eGFR beyond 1 year. DCDD contribution to total donor pool stood at 6.8 % (28/411).
Conclusions
DCDD kidneys in current study worked at par with DCDD kidney retrieved elsewhere in the world despite the existing roadblocks and challenges in India. Provided these challenges are overcome in coming days, DCDD can surely fill the void of current and future demand of kidneys in India for end-stage renal disease patients.