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

• Published in: Transplantation proceedings 2019-10, Vol.51 (8), p.2520-2522
• Main Authors: Tojimbara, Tamotsu, Yashima, Jun, Shirai, Hiroyuki, Masaki, Noriyuki, Tonsho, Makoto, Teraoka, Satoshi
• Format: Article
• Language: English
• Subjects: 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 and Organ Procurement - methods; Tissue Donors; Transplants - drug effects; Transplants - physiopathology; Treatment Outcome; Warm Ischemia
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2019.01.200

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. 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. 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. 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. •We adopted a modified method to resuscitate kidneys from donation after circulatory death donors (DCD) with the use of Euro-Collins (EC) solution instead of University of Wisconsin solution.•This study aimed to evaluate kidney transplantation outcomes of DCD kidneys procured with low-dose in situ perfusion using EC solution.•Kidney grafts procured from DCDs 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 DCDs under optimal conditions such as a relatively shorter preservation time.