Promising results of kidney transplantation from donors following euthanasia

J. Bollen

Wednesday 4 march 2020

12:50 - 13:00h at Theaterzaal

Parallel session: Plenaire sessie II - Best abstracts

Background: to examine the quality of kidneys transplanted following organ donation after euthanasia, compared to kidneys transplanted following other types of deceased donation. 

Organ donation after euthanasia is performed in Belgium, the Netherlands and Canada while the number of countries that allow physician assisted death is increasing. So far, the quality of kidneys donated and transplanted following euthanasia had not been investigated.

Methods: Data from all kidney transplantations from deceased organ donors in the Netherlands from 2012 to 2017 were obtained. Postoperative graft function and death-censored graft and recipient survival of kidneys from donors after euthanasia were compared with the results of kidneys donated after circulatory (DCD) and brain death (DBD).

Results: 73 kidneys transplanted following donation after euthanasia were compared with 1212 transplanted after DBD, and 1234 transplanted after DCD in the period 2012-2017. The incidence of immediate graft function in kidneys from donor after euthanasia was 70%, similar to DBD kidneys (74%, P= 0.56) and higher than other DCD kidneys (44%, P<0.001). The incidence of primary non-function was 7% and did not differ between donor types. Death-censored graft survival was 93% and recipient survival was 95% at 1 year after transplantation, was comparable to DBD and DCD kidneys.

Conclusions: Kidney transplantation following donation after euthanasia is associated with good short-term and medium term clinical outcomes, and is comparable to DBD and DCD kidneys. Outcome is not an obstacle in the implementation of organ donation after euthanasia in countries where the legal and ethical requirements have been met.