Do we need a different organ allocation system for kidney transplants using donors after circulatory death?

Shanka K. Benaragama*, Teressa Tymkewycz, Biku J. John, Andrew Davenport, [No Value] Ben Lindsey, David Nicol, Jonathon Olsburgh, Martin Drage, Nizam Mamode, Francis Calder, John Taylor, Geoff Koffman, Nicos Kessaris, Mohamed Morsy, Roberto Cacciola, Carmelo Puliatti, Susana Fernadez-Diaz, Asim Syed, Nadey Hakim, Vassilios PapaloisBimbi S. Fernando

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    7 Citations (Scopus)


    Background: There is no national policy for allocation of kidneys from Donation after circulatory death (DCD) donors in the UK. Allocation is geographical and based on individual/regional centre policies. We have evaluated the short term outcomes of paired kidneys from DCD donors subject to this allocation policy.

    Methods: Retrospective analysis of paired renal transplants from DCD's from 2002 to 2010 in London. Cold ischemia time (CIT), recipient risk factors, delayed graft function (DGF), 3 and 12 month creatinine) were compared.

    Results: Complete data was available on 129 paired kidneys. 115 pairs were transplanted in the same centre and 14 pairs transplanted in different centres. There was a significant increase in CIT in kidneys transplanted second when both kidneys were accepted by the same centre (15.5 +/- 4.1 vs 20.5 +/- 5.8 hrs p <0.0001 and at different centres (15.8 +/- 5.3 vs. 25.2 +/- 5.5 hrs p = 0.0008). DGF rates were increased in the second implant following sequential transplantation (p = 0.05).

    Conclusions: Paired study sequential transplantation of kidneys from DCD donors results in a significant increase in CIT for the second kidney, with an increased risk of DGF. Sequential transplantation from a DCD donor should be avoided either by the availability of resources to undertake simultaneous procedures or the allocation of kidneys to 2 separate centres.

    Original languageEnglish
    Article number83
    Number of pages7
    JournalBMC Nephrology
    Publication statusPublished - 22 May 2014


    • Donation after circulatory death
    • Allocation
    • Kidney
    • Delayed graft function
    • Cold ischemia time
    • ERA


    Dive into the research topics of 'Do we need a different organ allocation system for kidney transplants using donors after circulatory death?'. Together they form a unique fingerprint.

    Cite this