Deceased Donor Transplant
A deceased donor transplant is a transplant where the donated kidney comes from a person who has died.
For various reasons, many people do not have the opportunity for a living donor. Organs donated from deceased donors are used for about 40 percent of our kidney transplant recipients. Results for these recipients are excellent, but the waiting time to receive a deceased donor transplant may be months to many years.
There are several classifications of kidneys that come from deceased donors:
- Standard criteria donor (SCD)
- Extended criteria donor kidneys (ECD)
- Donation after cardiac death donors (DCD)
- High social risk donors
Standard Deceased Donor Transplant
A standard criteria donor kidney is a kidney that comes from a deceased donor under the age of 60 who is on life support and is declared brain dead. Brain death is defined as the irreversible loss of function of the brain while the heart is still beating keeping vital organs alive and available for transplantation.
Extended Deceased Donor Transplant
An extended criteria deceased donor kidney is a kidney that comes from a deceased donor who has the following risk factors:
- Age: the deceased donor is over age 60
- Age plus risk factors: the deceased donor is over 50 with 2 or more of the following risk factors:
- Donor has history of high blood pressure
- Donor died from stroke
- Donor has some kidney damage. Donor’s serum creatinine level is higher than normal
Donation after Cardiac Death
Donation after Cardiac Death refers to a donor whose heart has stopped beating. These donors are not brain dead, but the severity of their brain injury has led physicians and families to decide to remove life support and donate organs after their heart has stopped beating. After the patient’s heart stops and he or she is declared dead, the donor is taken to the operating room and the organs are removed.
High Social Risk Donors
A high social risk donors refers to a donor whose personal behaviors before death have been identified by the Centers for Disease Control (CDC) to place them at higher risk for transmission of infectious disease. Such behaviors include current use of recreational drugs, prostitution, or recent incarceration. These high-risk behaviors increase the possibility of transmitting hepatitis, HIV and other infections to the recipient. Because the elapsed time between the risky behavior and death is very short, conventional testing may not detect the presence of an infection.
Using the latest technology, called NAT testing, we can now make this detection process much faster, allowing use of kidneys from high-risk behaviour donors in a much safer way.
Acceptance of kidneys from high social risk donors is the decision of the recipient. We will ask early in your evaluation if you want to be considered for one of these kidneys, which may shorten your waiting list time. If you are offered a kidney from a high social risk donor, the transplant team will explain the risks to you so that you can make a decision on whether to accept the kidney offer. If you choose not to accept a high social risk donor, this will not affect your care with the Transplant Program nor will it change your position on the national wait list.
Helping you Weigh Options and Risks
Non-standard criteria donor kidneys carry increased risks of early and late loss of the kidney. However, data shows that your survival rate is better with a non-standard criteria kidney than waiting on dialysis. For some patients a non-standard criteria kidney is a good option.
If a non-standard criteria donor kidney becomes available and is a match for you, your Swedish physicians, surgeons, and support staff will review with you specific aspects of your medical situation, the donor and the donor kidney to help you make a decision about whether or not this kidney is for you.
More information about extended criteria donor kidney can be found at the American Society of Transplantation.