![]() If transported from another centre, the kidney will arrive stored in perfusion fluid (within sterile bags) and surrounded by ice. for living and DBD donors this is at the point of ligation of the renal artery, whilst for DCD donors this is at the point of cardiac arrest) until perfusion with preservation solution.Ĭold ischaemia time (CIT) is the time from the perfusion of the organ with the preservation solution to re-perfusion of the organ with recipient blood after the implant’s vascular anastomosis. Warm ischaemia time (WIT) is the time between the cessation of organ perfusion by the donor’s blood circulation (i.e. The mortality of donor nephrectomy is low, estimated at 1 in 3000 for all surgical approaches. Again, the kidney, once removed, should be flushed with preservation fluid as soon as possible. The left kidney is preferred because of a longer renal vein, however no patch of aorta or IVC can be taken in these cases. The organs are then taken to the back table for further examination and perfusion.įor living donor kidney transplantation, the nephrectomy is most commonly performed via a laparoscopic technique. The kidneys are then removed with the renal artery with a patch of aorta, the renal vein with a patch of the IVC, and the ureter. The donor is heparinised, then the vessels and ureter(s) are identified and isolated. During DCD retrieval, a rapid cannulation of the iliac artery with cold perfusion is performed to limit the exposure of the organs to warm ischaemia.įull exposure of the abdomen is obtained and the bowel is mobilised to access to the retroperitoneal space. In DBD retrievals, there is also a period of dissection which allows assessment of the organs during the procurement process. Organs are retrieved in a similar fashion using cold perfusion during both DBD and DCD retrievals. Surgical Techniques Donor Retrieval Procedure Table 1 – Contraindications to renal transplantation ![]() IndicationsĪll patients with end stage renal failure (GFR65 years One year survival for DBD transplant recipients is around 97% and for living donor transplant recipients is around 99%. Living-donor transplants account for up to 30% of all kidney transplantations, either related or unrelated, performed as a laparoscopic donor nephrectomy (rarely this is done as an open nephrectomy in modern practice). ![]() Deceased donors are either Donation after Brainstem Death (DBD) or Donation after Circulatory Death (DCD). Kidneys can be donated from either living donors or deceased donors, with the majority of renal transplants from deceased donors. Renal transplantation (RT) is the treatment of choice for patients with end-stage renal disease (ESRD). ![]()
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