Introduction: While living donor kidney transplantation is preferred and encouraged, the majority do not have that option for various reasons and are wait listed for a deceased donor kidney transplant on the national waiting list. Maximizing the use of Donation after Circulatory Death (DCD) and high Kidney Donor Profile Index (KDPI) kidneys would thereby reduce the time on the wait list and increase the preemptive transplants, avoiding dialysis altogether.
Method: At our transplant center, the criteria for accepting a deceased donor kidney are kept wider especially for the kidneys offered within our own Organ Procurement Organization (OPO). Based on the quality of the donor kidney, recipients are selected appropriately with informed consent.
Recipients are especially warned about higher likelihood of delayed graft function and therefore, the need for a post-transplant dialysis for few days till the transplant allograft recovers function.
Results: Between January 1, 2022 and December 2023, a total of 76 kidney transplants were performed at Sanford Health, Fargo. A total of 22 were living donor and 54 were deceased donor transplants. In this report we only analyzed the deceased donor transplants. There were 33 male and 21 females. The mean age was 51 (range 21 to 74) years. Forty-four patients received their first, 8 patients received their second, one patient received their 3rd, and one patient received her 4th renal transplant. Thirteen (24%) of them were pre-emptive kidney transplants.
Conclusion: Through the judicious use of donation after circulatory death and high KDPI kidneys, a greater number of kidney transplants can be performed. This helps reduce the discard rate, reduce the time on wait list for those already on dialysis improving their quality of life and reducing their mortality while on dialysis, increase the number of pre-emptive transplants completely avoiding the need for dialysis and easing the already overcrowded dialysis units.