Session Name: Kidney Deceased Donor Selection
Session Date & Time: None. Available on demand.
*Purpose: The deceased Organ Donation rate is around 0.8/million in our nation. There remains a severe shortage of organs worldwide, leading to a trend towards relaxing acceptance criteria for using organs. However, after these donations, outcomes need to be carefully analyzed to have guidelines for the safe use of organs from these donors. The present study analyzed the outcomes after using organs from Deceased Organ Donors (DOD) with sepsis in a kidney-pancreas transplant program at a tertiary care hospital
*Methods: Data from January 2016 -October 2019 was analyzed from the local database. A total of 118 DOD were identified. 37/118(31.3%) fulfilled the criteria of ongoing sepsis any time before organ donation. Sepsis was defined as a positive blood/urine/tracheal aspirate cultures and a positive Sequential Organ Failure Assessment score (SOFA). Cultures sent on any day after ICU admission till organ procurement were included. Parametric and nonparametric multivariate analysis was done among these DODs
*Results: Over 95% of donors had brain death due to road traffic accidents with a mean ICU stay of 7.3+ 6.3 days. 235 recipients received kidneys and pancreas from these donors, and 73 of these were from septic donors. Among 37 septic organ donors, 19 had multiple drug-resistant organisms (MDRO) on cultures, most commonly being Acinetobacter baumannii. A total of 6/235 Recipients had died during the hospital stay, with most (5/6) of these in patients who received kidneys from septic donors. Recipients from septic donors had Significantly higher DGF rates, required more post-op re-explorations (11. Vs. 4.9%), and had longer ICU stay, 19.8 vs. 15.6 days
*Conclusions: Organ transplantation from donors with sepsis resulted in higher mortality in the early post-op period. There is a need to characterize risk factors associated with mortality in these donors. However, long-term outcomes were similar in patients who recovered
|Total (n-236)||Sepsis YES (n-recipient)||Sepsis NO (n-recipient)||Multivariate significance|
|DCD/DBD||7/66 (73)= 31.0%||4/159 (162) = 68.9%|
|Recipient age & Donor Age||41.6 & 35||40.8 & 35.5|
|Cold ischemia Time(min)||347.41||357.87|
|In stay Rejection||8.2%||11.6%|
|Discharge sCr vs follow-up sCr (mg/dl)||1.67 vs 1.29||1.50 vs 1.09|
|Patient survival at 3 years||62/73= 84.9%||148/162= 91.3%|
To cite this abstract in AMA style:Sharma A, Choudhary D, Kenwar D, Singh S, kumar S, jain K, Bansal N, Ravi A. Outcomes After Usage of Organs from Deceased Organ Donors with Sepsis – A Single-center Experience [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-after-usage-of-organs-from-deceased-organ-donors-with-sepsis-a-single-center-experience/. Accessed July 24, 2021.
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