A Re-evaluation of Discarded Deceased Donor Kidneys in the UK: Are Usable Organs Still Being Discarded?

Shruti Mittal, Anna Adamusiak, Catherine Horsfield, Ioannis Loukopoulos, Nikolaos Karydis, Nicos Kessaris, Martin Drage, Jonathon Olsburgh, Christopher Je Watson, Chris J. Callaghan

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1698-1703
Number of pages6
JournalTransplantation
Volume101
Issue number7
DOIs
StatePublished - Jul 1 2017

Bibliographical note

Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.

Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.

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