Skip to main content
SpringerLink
Log in

Kidney donation after circulatory death: current evidence and opportunities for pediatric recipients

  • Review
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Organ donation after circulatory death (DCD) has experienced a revival worldwide over the past 20 years, and is now widely practiced for kidney transplantation. Some previous concerns about these organs such as the high incidence of delayed graft function have been alleviated through evidence from adult studies. There are now a number of large adult cohorts reporting favorable 5-year outcomes for DCD kidney transplants, comparable to kidneys donated after brain death (DBD). This has resulted in a marked increase in the use of DCD kidneys for adult recipients in some countries and an increase in the overall number of kidney transplants. In contrast, the uptake of DCD kidneys for pediatric recipients is still low and concerns still exist over the longer-term outcomes of DCD organs. In view of the data from adult practice and the poor outcomes for children who stay on dialysis, DCD kidney transplantation should be offered as an option for children on the kidney transplant waiting list.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Morrissey PE, Monaco AP (2014) Donation after circulatory death: current practices, ongoing challenges, and potential improvements. Transplantation 97:258–264

    Article  PubMed  Google Scholar 

  2. Akoh JA (2012) Kidney donation after cardiac death. World J Nephrol 1:79–91

    Article  PubMed  PubMed Central  Google Scholar 

  3. Pascual J, Zamora J, Pirsch JD (2008) A systematic review of kidney transplantation from expanded criteria donors. Am J Kidney Dis 52:553–586

    Article  PubMed  Google Scholar 

  4. Saidi RF, Elias N, Kawai T, Hertl M, Farrell ML, Goes N, Wong W, Hartono C, Fishman JA, Kotton CN, Tolkoff-Rubin N, Delmonico FL, Cosimi AB, Ko DS (2007) Outcome of kidney transplantation using expanded criteria donors and donation after cardiac death kidneys: realities and costs. Am J Transplant 7:2769–2774

    Article  CAS  PubMed  Google Scholar 

  5. Domínguez-Gil B, Haase-Kromwijk B, Van Leiden H, Neuberger J, Coene L, Morel P, Corinne A, Muehlbacher F, Brezovsky P, Costa AN, Rozental R, Matesanz R, European Committee (Partial Agreement) on Organ Transplantation. Council of Europe (CD-P-TO) (2011) Current situation of donation after circulatory death in European countries. Transplant Int 24:676–686

    Article  Google Scholar 

  6. Summers DM, Johnson RJ, Allen J, Fuggle SV, Collett D, Watson CJ, Bradley JA (2010) Analysis of factors that affect outcome after transplantation of kidneys donated after cardiac death in the UK: a cohort study. Lancet 376:1303–1311

    Article  PubMed  Google Scholar 

  7. Maggiore U, Oberbauer R, Pascual J, Viklicky O, Dudley C, Budde K, Sorensen SS, Hazzan M, Klinger M, Abramowicz D, ERA-EDTA-DESCARTES Working Group (2015) Strategies to increase the donor pool and access to kidney transplantation: an international perspective. Nephrol Dial Transplant 30:217–222

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wadei HM, Heckman MG, Rawal B, Taner CB, Farahat W, Nur L, Mai ML, Prendergast M, Gonwa TA (2013) Comparison of kidney function between donation after cardiac death and donation after brain death kidney transplantation. Transplantation 96:274–281

    Article  PubMed  Google Scholar 

  9. Nagaraja P, Roberts GW, Stephens M, Horvath S, Fialova J, Chavez R, Asderakis A, Kaposztas Z (2012) Influence of delayed graft function and acute rejection on outcomes after kidney transplantation from donors after cardiac death. Transplantation 94:1218–1223

    Article  PubMed  Google Scholar 

  10. Andrews PA, Burnapp L, Manas D (2014) Summary of the British Transplantation Society guidelines for transplantation from donors after deceased circulatory death. Transplantation 97:265–270

    Article  PubMed  Google Scholar 

  11. Gardiner D, Shemie S, Manara A, Opdam H (2012) International perspective on the diagnosis of death. Br J Anaesth 108(Suppl 1):i14–28

    Article  PubMed  Google Scholar 

  12. Neyrinck A, Van Raemdonck D, Monbaliu D (2013) Donation after circulatory death: current status. Curr Opin Anaesth 26:382–390

    Google Scholar 

  13. Reid AWN, Harper S, Jackson CH, Wells AC, Summers DM, Gjorgjimajkoska O, Sharples LD, Bradley JA, Pettigrew GJ (2011) Expansion of the kidney donor pool by using cardiac death donors with prolonged time to cardiorespiratory arrest. Am J Transplant 11:995–1005

    Article  CAS  PubMed  Google Scholar 

  14. Cantafio AW, Dick AA, Halldorson JB, Bakthavatsalam R, Reyes JD, Perkins JD (2011) Risk stratification of kidneys from donation after cardiac death donors and the utility of machine perfusion. Clin Transplant 25:E530–540

    Article  CAS  PubMed  Google Scholar 

  15. De Vries EE, Snoeijs MG, Van Heurn E (2010) Kidney donation from children after cardiac death. Crit Care Med 38:249–253

    Article  PubMed  Google Scholar 

  16. Manara AR, Murphy PG, O’Callaghan G (2012) Donation after circulatory death. Br J Anaesth 108(Suppl):i108–121

    Article  PubMed  Google Scholar 

  17. Sung RS (2010) Transplantation: pediatric kidney donation after cardiac death. Nat Rev Nephrol 6:387–388

    Article  PubMed  Google Scholar 

  18. Martin DE, Nakagawa TA, Siebelink MJ, Bramstedt KA, Brierley J, Dobbels F, Rodrigue JR, Sarwal M, Shapiro R, Dominguez-Gil B, Danovitch G, Sweet SC, Trompeter RS, Moazam F, Bos MA, Delmonico FL (2015) Pediatric deceased donation—a report of the Transplantation Society meeting in Geneva. Transplantation 99:1403–1409

    Article  CAS  PubMed  Google Scholar 

  19. De Vries EE, Hoogland PER, Wind J, Snoeijs MG, van Heurn EL (2013) Transplantation of kidneys from paediatric DCD donors: a comparison with DBD donors. Nephrol Dial Transplant 28:220–226

    Article  PubMed  Google Scholar 

  20. Shore PM, Huang R, Roy L, Darnell C, Grein H, Robertson T, Thompson L (2011) Potential for liver and kidney donation after circulatory death in infants and children. Pediatrics 28:e631–638

    Google Scholar 

  21. Hanley H, Kim S, Willey E, Castleberry D, Mathur M (2014) Identifying potential kidney donors among newborns undergoing circulatory determination of death. Pediatrics 133:e82–87

    Article  PubMed  Google Scholar 

  22. Atreja G, Godambe S (2015) First neonatal organ donation in the UK. Arch Dis Child Fetal Neonatal Ed 100:F276–F277

  23. Dion M, Rowe N, Shum J, Weernink C, Felbel S, McAlister VC, Sener A, Luke PP (2015) Donation after cardiac death pediatric en bloc renal transplantation. J Urol 193:281–285

    Article  PubMed  Google Scholar 

  24. Ausania F, White SA, Pocock P, Manas DM (2012) Kidney damage during organ recovery in donation after circulatory death donors: data from UK National Transplant Database. Am J Transplant 12:932–936

    Article  CAS  PubMed  Google Scholar 

  25. Bon D, Chatauret N, Giraud S, Thuillier R, Favreau F, Hauet T (2012) New strategies to optimize kidney recovery and preservation in transplantation. Nat Rev Nephrol 8:339–347

    Article  CAS  PubMed  Google Scholar 

  26. Oniscu GC, Randle LV, Muiesan P, Butler AJ, Currie IS, Perera MT, Forsythe JL, Watson CJ (2014) In situ normothermic regional perfusion for controlled donation after circulatory death--the United Kingdom experience. Am J Transplant 14:2846–2854

    Article  CAS  PubMed  Google Scholar 

  27. Jochmans I, Moers C, Smits JM, Leuvenink HG, Treckmann J, Paul A, Rahmel A, Squifflet JP, van Heurn E, Monbaliu D, Ploeg RJ, Pirenne J (2010) Machine perfusion versus cold storage for the preservation of kidneys donated after cardiac death: a multicenter, randomized, controlled trial. Ann Surg 252:756–764

    Article  PubMed  Google Scholar 

  28. Watson CJ, Wells AC, Roberts RJ, Akoh JA, Friend PJ, Akyol M, Calder FR, Allen JE, Jones MN, Collett D, Bradley JA (2010) Cold machine perfusion versus static cold storage of kidneys donated after cardiac death: a UK multicenter randomized controlled trial. Am J Transplant 10:1991–1999

    Article  CAS  PubMed  Google Scholar 

  29. Nicholson ML, Hosgood SA (2013) Renal transplantation after ex vivo normothermic perfusion: the first clinical study. Am J Transplant 13:1246–1252

    Article  CAS  PubMed  Google Scholar 

  30. Summers DM, Counter C, Johnson RJ, Murphy PG, Neuberger JM, Bradley JA (2010) Is the increase in DCD organ donors in the United Kingdom contributing to a decline in DBD donors? Transplantation 90:1506–1510

    Article  PubMed  Google Scholar 

  31. Foster BJ, Dahhou M, Zhang X, Platt RW, Hanley JA (2013) Relative importance of HLA mismatch and donor age to graft survival in young kidney transplant recipients. Transplantation 96:469–475

    Article  PubMed  Google Scholar 

  32. Terasaki PI, Cecka JM, Gjertson DW, Takemoto S (1995) High survival rates of kidney transplants from spousal and living unrelated donors. N Engl J Med 333:333–336

    Article  CAS  PubMed  Google Scholar 

  33. Cho YW, Terasaki PI, Cecka JM, Gjertson DW (1998) Transplantation of kidneys from donors whose hearts have stopped beating. N Engl J Med 338:221–225

    Article  CAS  PubMed  Google Scholar 

  34. Le Dinh H, Weekers L, Bonvoisin C, Krzesinski JM, Monard J, de Roover A, Squifflet JP, Meurisse M, Detry O (2012) Delayed graft function does not harm the future of donation-after-cardiac death in kidney transplantation. Transplant Proc 44:2795–2802

    Article  PubMed  Google Scholar 

  35. Saat TC, Susa D, Roest HP, Kok NF, van den Engel S, Ijzermans JN, de Bruin RW (2014) A comparison of inflammatory, cytoprotective and injury gene expression profiles in kidneys from brain death and cardiac death donors. Transplantation 98:15–21

    Article  CAS  PubMed  Google Scholar 

  36. Summers DM, Johnson RJ, Hudson A, Collett D, Watson CJ, Bradley JA (2013) Effect of donor age and cold storage time on outcome in recipients of kidneys donated after circulatory death in the UK: a cohort study. Lancet 381:727–734

    Article  PubMed  Google Scholar 

  37. Summers DM, Watson CJ, Pettigrew GJ, Johnson RJ, Collett D, Neuberger JM, Bradley JA (2015) Kidney donation after circulatory death (DCD): state of the art. Kidney Int 88:241–249

  38. Snoeijs MG, Schaubel DE, Hené R, Hoitsma AJ, Idu MM, Ijzermans JN, Ploeg RJ, Ringers J, Christiaans MH, Buurman WA, van Heurn LW (2010) Kidneys from donors after cardiac death provide survival benefit. J Am Soc Nephrol 21:1015–1021

    Article  PubMed  PubMed Central  Google Scholar 

  39. Snyder RA, Moore DR, Moore DE (2013) More donors or more delayed graft function? A cost-effectiveness analysis of DCD kidney transplantation. Clin Transplant 27:289–296

    Article  PubMed  Google Scholar 

  40. Abt P, Kashyap R, Orloff M, Jain A, Tsoulfas G, Bozorgzadeh A, Olthoff K (2006) Pediatric liver and kidney transplantation with allografts from DCD donors: a review of UNOS data. Transplantation 82:1708–1711

    Article  PubMed  Google Scholar 

  41. McDonald SP, Craig JC (2004) Long-term survival of children with end-stage renal disease. N Eng J Med 350:2654–2662

    Article  CAS  Google Scholar 

  42. Yoo PS, Olthoff KM, Abt PL (2011) Donation after cardiac death in pediatric organ transplantation. Curr Opin Organ Transplant 16:483–488

    Article  PubMed  Google Scholar 

  43. Johnson RJ, Bradbury LL, Martin K, Neuberger J, UK Transplant Registry (2014) Organ donation and transplantation in the UK-the last decade: a report from the UK National Transplant Registry. Transplantation 97(Suppl 1):S1–S27

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK

    Matko Marlais & Stephen D. Marks

  2. Department of Nephrology and Transplantation, Guy’s Hospital, Great Maze Pond, London, SE1 9RT, UK

    Chris Callaghan

  3. Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK

    Stephen D. Marks

Authors
  1. Matko Marlais
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chris Callaghan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephen D. Marks
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephen D. Marks.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marlais, M., Callaghan, C. & Marks, S.D. Kidney donation after circulatory death: current evidence and opportunities for pediatric recipients. Pediatr Nephrol 31, 1039–1045 (2016). https://doi.org/10.1007/s00467-015-3175-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-015-3175-6

Keywords

Search

Navigation