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Original article

Vol. 141 No. 2930 (2011)

Organ donation in Switzerland: a survey on marginal or extended criteria donors (ECD) from 1998 to 2009

  • M Otth
  • S Rödder
DOI
https://doi.org/10.4414/smw.2011.13230
Cite this as:
Swiss Med Wkly. 2011;141:w13230
Published
18.07.2011

Summary

BACKGROUND: The widening gap between the numbers of patients on the waiting list for organ transplantation and the insufficient numbers of organ donors results in the use of “critical” donors, so-called marginal donors orextended criteria donors. Data concerning the evaluation of extended criteria donors (ECD) in Switzerland are sparse.

METHODS: All organ donors in Switzerland between 1.1.1998 and 30.6.2009 have been evaluated for special criteria. ECD were defined on the basis of at least one of seven criteria: six DOPKI criteria (ECD-DOPKI) and/or age ≥60 yr (ECD-Age). Once included in the study, special features, short time follow-up (first 7 days after transplantation) and the cold ischaemia time of all the transplanted organs were evaluated.

RESULTS: During the period 1.1.1998 to 30.6.2009, a total of 408 organ donors were classified as ECD, reflecting 39% of all organ donors in this time period. Despite the fact that all organ donors in this study fulfilled at least one inclusion criterion, the number of recipients with satisfactory primary organ function was always higher than the respective numberwith a negative primary outcome within the first seven days after transplantation. A longer cold ischaemia time was associated with organs showing insufficient primary organ function compared to organs with satisfactory primary function. A relevant causal relationship cannot be investigated on the basis of our limited data. In addition, a longer observation period would be necessary to draw a more precise conclusion.

CONCLUSIONS: ECD as defined by DOPKI and/or age represent a high proportion of all organ donors in Switzerland but show a remarkably good outcome.

References

  1. DOPKI Improving the knowledge and practices in organ donation. Final Report of Work packages; http://www.dopki.eu
  2. Ojo AO, Hanson JA, Meier-Kriesche HU, Okechukwu CN, Wolfe RA, Leichtman AB, et al. Survival in Recipients of Marginal Cadaveric Donor Kidneys Compared with Other Recipients and Wait-Listed Transplant Candidates. J Am Soc Nephrol. 2001;12:589–97.
  3. Blanche C, Kamlot A, Blanche DA, Kearney B, Magliato KE, Czer LSC, et al. Heart transplantation with donors fifty years of age and older. J Thorac Cardiovasc Surg. 2002;123:810–5.
  4. DOPKI Improving the knowledge and practices in organ donation. Final Report of Work packages; http://www.dopki.eu
  5. Topkara VK, Cheema FH, Kesavaramanujam S, Mercando ML, Forster CS, Argenziano M, et al. Effect of Donor Age on Long-Term Survival Following Cardiac Transplantation. J Card Surg. 2006;21:125–9.
  6. Beyeler et al. Organs, Tissues, Cells, 2009.
  7. Tsao CI, Chen RJ, Chou NK, Ko WJ, Chi NH, Yu HY, et al. The Influence of Donor Characteristics on Survival After Heart Transplantation. Transplantation Proceedings, Volume 40, Issue 8, Pages 2636–7.
  8. Kawut SM, Reyentovich A, Wilt JS, Anzeck R, Lederer DJ, O’Shea MK, et al. Outcomes of extended donor lung recipients after lung transplantation. Transplantation. 2005;79(3):310–6.
  9. Durand F, Renz JF, AlkoferB,Burra P, Clavien PA,Porte RJ, et al. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation. Liver Transpl. 2008;14:1694–707.
  10. http://www.unos.org/docs/Kidney_Brochure.pdf
  11. Nickkholgh A, Weitz J, Encke J, Sauer P, Mehrabi A, Bückler MW, et al. Utilization of extended donor criteria in liver transplantation: a comprehensive review of the literature. Nephrol Dial Transplant. 2007;22(Suppl 8):viii29–viii36.
  12. Orens JB, Boehler A, de Perrot M, Estenne M, Glanville AR, Keshavjee S, et al. A review of lung transplant donor acceptability criteria. J Heart Lung Transplant. 2003;22(11):1183–200.