10.17863/CAM.11319
Mittal, Shruti
Adamusiak, Anna
Horsfield, Catherine
Loukopoulos, Ioannis
Karydis, Nikolaos
0000-0002-5729-552X
Kessaris, Nicos
Drage, Martin
Olsburgh, Jonathon
Watson, Christopher
0000-0002-0590-4901
Callaghan, Chris J
A Re-evaluation of Discarded Deceased Donor Kidneys in the UK: Are Usable Organs Still Being Discarded?
Apollo - University of Cambridge Repository (staging)
2017
Humans
Postoperative Complications
Treatment Outcome
Kidney Transplantation
Donor Selection
Cause of Death
Risk Assessment
Risk Factors
Predictive Value of Tests
Program Evaluation
Graft Survival
Decision Support Techniques
Time Factors
Adult
Aged
Aged, 80 and over
Middle Aged
Tissue Donors
Tissue and Organ Procurement
Female
Male
United Kingdom
Apollo - University of Cambridge Repository (staging)
Apollo - University of Cambridge Repository (staging)
2017-07
Article
0041-1337
1534-6080
BACKGROUND: A significant proportion of procured deceased donor kidneys are subsequently discarded. The UK Kidney Fast-Track Scheme (KFTS) was introduced in 2012, enabling kidneys at risk of discard to be simultaneously offered to participating centers. We undertook an analysis of discarded kidneys to determine if unnecessary organ discard was still occurring since the KFTS was introduced. METHODS: Between April and June 2015, senior surgeons independently inspected 31 consecutive discarded kidneys from throughout the United Kingdom. All kidneys were biopsied. Organs were categorized as usable, possibly usable pending histology, or not usable for implantation. After histology reports were available, final assessments of usability were made. RESULTS: There were 19 donors (6 donations after brain death, 13 donations after circulatory death), with a median (range) donor age of 67 (29-83) years and Kidney Donor Profile Index of 93 (19-100). Reasons for discard were variable. Only 3 discarded kidneys had not entered the KFTS. After initial assessment postdiscard, 11 kidneys were assessed as usable, with 9 kidneys thought to be possibly usable. Consideration of histological data reduced the number of kidneys thought usable to 10 (10/31; 32%). CONCLUSIONS: The KFTS scheme is successfully identifying organs at high risk of discard, though potentially transplantable organs are still being discarded. Analyses of discarded organs are essential to identify barriers to organ utilization and develop strategies to reduce unnecessary discard.