The role and problems of posthumous donation and surgical features of organ explantation
DOI:
https://doi.org/10.11603/2414-4533.2022.2.12879Keywords:
organ donation, explantation, brain death, organ transplantationAbstract
The aim of the work: to determine the proportion of organs suitable for transplantation and the surgical features of organ explantations from post-mortem donors.
Materials and methods. The study included 14 post-mortem donors who met the safety criteria of a potential donor and who underwent organ explantation from May 2021 to December 2021 on the basis of Kyiv Regional Clinical Hospital, 14 % (2 people) of them are over 60 years old and 86% (12 people ) under 60 years of age.
Results and Discussion. According to the results of this reseach, it can be argued that despite the laboratory indicators of donor safety, some organs are not suitable for further transplantation for various reasons. In addition, every third or fourth explantation is accompanied by variable vascular anatomy.
Conclusions. The modern development of transplantation in our country has allowed us to significantly improve the results in the fight for the lives of patients. So, posthumous donation saves the life of at least 4 people. At the same time, this study demonstrates that 36 % of hearts, 43 % of liver and 7 % of kidneys can not be used for transplantation if the laboratory criteria for donor safety are met. Variable vascular anatomy occurs in 25 % of explanted livers and 39% of kidneys, which lengthens the time of organ explantation and, accordingly, the period of cold ischemia.
References
Heldal, K., Hartmann, A., Leivestad, T., Lien, B., Foss, A.E., & Midtvedt, K. (2011). Renal transplantation is also an option for patients over 70. Tidsskr. Nor. Laegeforen., 131 (20), 2004-2007. DOI: 10.4045/tidsskr.10.1391. PMID: 22016126.
Yilmaz, G., Ozdemir, E., Yildar, M., Karayagiz, H., Berber, I., & Cakir, U. (2022). Graft and patient survival in kidney transplant recipients over the age of sıxty-five. Cureus, 14 (1), e20913. DOI: 10.7759/cureus.20913. PMID: 35154914; PMCID: PMC8815706.
Stephan, A. (2017). Organ shortage: Can we decrease the demand? Experimental and clinical transplantation: Official Journal of the Middle East Society for Organ Transplantation, Suppl. 1, 6-9. DOI: 10.6002/ect.mesot2016.l27. PMID: 28260423.
Levitt, M. (2015). Could the organ shortage ever be met? Life Sci. Soc. Policy, 11, 6 https://doi.org/10.1186/s40504-015-0023-1
Saidi, R.F., & Hejazii Kenari, S.K. (2014). Challenges of organ shortage for transplantation: solutions and opportunities. Int. J. Organ Transplant. Med., 5 (3), 87-96. PMID: 25184029; PMCID: PMC4149736.
Getchell, L.E., McKenzie, S.Q., Sontrop, J.M., Hayward, J.S., McCallum, M.K., & Garg, A.X. (2017). Increasing the rate of living donor kidney transplantation in Ontario: donor- and recipient-identified barriers and solutions. Can. J. Kidney Health Dis., 4, 2054358117698666.
Reed, R.D., Sawinski, D., Shelton, B.A. (2018). Population health, ethnicity, and rate of living donor kidney transplantation. Transplantation, 102, 2080.
Maria Messina, Davide Diena, Sergio Dellepiane, Gabriella Guzzo, Luca Lo Sardo, Fabrizio Fop, Giuseppe P. Segoloni, Antonio Amoroso, Paola Magistroni, Luigi Biancone (2017). Long-term outcomes and discard rate of kidneys by decade of extended criteria donor age. CJASN, 12 (2), 323-331; DOI: 10.2215/CJN.06550616.
Bozkurt, B., Kılıç, M. (2015). Marginal donors in renal transplantation, transplantation proceedings. 47, Issue 5, 1273-1281. ISSN 0041-1345, https://doi.org/10.1016/j.transproceed.2015.04.006.
Bae, S., Massie, A.B., Thomas, A.G., Bahn, G., Luo, X., Jackson, K.R., … Garonzik Wang, J.M. (2018). Who can tolerate a marginal kidney? Predicting survival after deceased donor kidney transplant by donor-recipient combination. American Journal of Transplantation, DOI:10.1111/ajt.14978
Baranski, A. (2009). Surgical technique of the abdominal organ procurement. DOI:10.1007/978-1-84800-251-7.
Alfaro, A.G., Hernández, P.C., Gómez, E.G., Garcia, J.R., Carazo, J.L.C., López, F.M., Tapia, M.J.R. (2013). Variations in initial renal transplant function by type of organ retrieval. Transplantation Proceedings, 45 (10), 3603-3605. DOI:10.1016/j.transproceed.2013.02.026
Bessede, T., Droupy, S., Hammoudi, Y., Bedretdinova, D., Durrbach, A., Charpentier, B., Benoit, G. (2012). Surgical prevention and management of vascular complications of kidney transplantation. Transpl. Int., 25 (9), 994-1001.
Tavakkoli, M., Zafarghandi, R.M., Taghavi, R., Ghoreifi, A., & Zafarghandi, M.M. (2017). Immediate vascular complications after kidney transplant: Experience from 2100 recipients. Exp. Clin. Transplant., 15 (5), 504-508. DOI: 10.6002/ect.2016.0057. Epub 2016 Dec 2.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Hospital Surgery. Journal named by L.Ya. Kovalchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
