Low-dose In Situ Perfusion With Euro-Collins Solution Is Effective for the Procurement of Marginal Kidney Grafts From Donation After Circulatory Death Donors

Transplant Proc. 2019 Oct;51(8):2520-2522. doi: 10.1016/j.transproceed.2019.01.200. Epub 2019 Aug 6.

Abstract

We have adopted a modified method to resuscitate kidneys from donation after circulatory death (DCD) donors with the use of Euro-Collins (EC) solution instead of University of Wisconsin solution. This study aimed to evaluate kidney transplantation (KTx) outcomes of DCD procured with low-dose in situ perfusion using EC solution.

Patients and methods: KTx was performed in 8 adults. Kidney grafts were procured following in situ perfusion with approximately 1 L of EC solution and preserved in the solution. The kidney donor profile index value was 88% ± 21%. The terminal creatinine level of the donors was 5.5 ± 3.4 mg/dL. Of the 8 donors, 6 experienced oligoanuria prior to graft procurement.

Results: The mean age of the recipients and the hemodialysis vintage were 50 ± 10 years and 161 ± 25 months, respectively. The warm and cold ischemic times were 8.3 ± 7.9 minutes and 8.7 ± 4.3 hours, respectively. All grafts functioned after a delayed graft function of 10.6 ± 6.9 days (2-25 days). There was neither immediate graft function nor primary nonfunction. The patient and graft survivals were both 100% with a terminal creatinine level of 1.3 ± .5 mg/dL.

Conclusions: Kidney grafts procured from DCD donors with a high kidney donor profile index value demonstrated good renal function with an excellent midterm outcome. Low-dose in situ perfusion with EC solution is effective for the procurement of marginal kidney grafts from DCD donors under optimal conditions such as a relatively shorter preservation time.

MeSH terms

  • Adult
  • Cold Ischemia
  • Creatinine / analysis
  • Death
  • Delayed Graft Function / etiology
  • Female
  • Graft Survival*
  • Humans
  • Hypertonic Solutions / administration & dosage*
  • Kidney / drug effects
  • Kidney / physiopathology
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Organ Preservation / methods*
  • Perfusion / methods*
  • Tissue Donors
  • Tissue and Organ Procurement / methods
  • Transplants / drug effects
  • Transplants / physiopathology
  • Treatment Outcome
  • Warm Ischemia

Substances

  • Euro-Collins' solution
  • Hypertonic Solutions
  • Creatinine