Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/112760
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Type: Journal article
Title: Challenges of kidney paired donation transplants involving multiple donor and recipient surgeons across Australia
Author: Allen, R.
Pleass, H.
Woodroffe, C.
Clayton, P.
Ferrari, P.
Citation: ANZ Journal of Surgery, 2018; 88(3):167-171
Publisher: Wiley
Issue Date: 2018
ISSN: 1445-1433
1445-2197
Statement of
Responsibility: 
Richard D. M. Allen, Henry C. C. Pleass, Claudia Woodroffe, Philip A. Clayton and Paolo Ferrari
Abstract: Background: The Australian kidney paired donation program adopted the principles of within-chain simultaneous live donor surgery and of organ transport, with the requirement of keeping cold ischemia time (CIT) to <12 h. Whether these principles could be adhered to and what impact on transplant outcome they might have is unknown. Methods: We evaluated the logistic challenges and outcomes of the first 100 kidney transplants performed in the Australian kidney paired donation program. Results: Within 4 years, 17 donor surgeons at 12 centres were involved in 37 chain exchange surgeries. Sixteen kidneys were transplanted at the same hospital and 84 required transport to the recipient hospital. Mean (±SD) within chain anaesthetic induction time variability was 8 ± 18 min and mean individual surgeon operating time was 115 ± 44 min. In two cases, delays during donor surgery resulted in increased CIT by 1 h because of deferred transport. CIT was 2.6 ± 0.6 h for non-shipped and 6.8 ± 2.8 h for shipped kidneys, four kidneys had CIT of 12–14 h. Immediate allograft function was observed in 85% of recipients, with no difference between shipped and non-shipped kidneys. There were only two cases of delayed graft function requiring temporary dialysis; both had CIT <7 h. There was no difference in serum creatinine at 1 month between non-shipped and shipped kidneys (105 ± 26 versus 112 ± 50 μmol/L) and allograft survival at 1 year was 97%. Conclusion: The study provided a favourable audit of kidney transplant activity, despite challenges of simultaneous surgery, organ transport coordination and prolonged CIT. The decision to ship donor kidneys rather than the donor was demonstrated to be feasible and safe.
Keywords: cold ischaemia time
delayed graft function
kidney paired donation
living donor kidney transplantation
organ transport
surgical audit
Rights: © 2016 Royal Australasian College of Surgeons
DOI: 10.1111/ans.13517
Appears in Collections:Aurora harvest 3
Surgery publications

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