Assessment of Donation Potential After Circulatory Death as the First Step in Implementing and Running a Hospital Program of Organ Procurement.

BACKGROUND: In Poland the potential for organ donation from donation after circulatory death (DCD) donors is not known. This assessment will allow the hospital to create a quality organ harvesting system from this group of donors. AIMS: The aim of this study was to assess the DCD potential based on retrospective analysis of hospital deaths at Hospital Infant Jesus in Warsaw. METHODS: Documentation of 718 deceased patients from 2010 to 2014 was analyzed. This population could be classified as potential DCD donors in IIb category. The deceased's characteristics were analyzed while undergoing the qualification process for DCD. The analysis was to confirm the presence or absence of factors disqualifying kidneys from donation and transplantation. Data from particular departments and from the entire hospital were analyzed. RESULTS: The total number of deaths was 718. Excluding factors from the DCD donation process were found in 664 cases (92%), mainly age >60 and concomitant diseases. The rest of the patients (n = 54.8%) did not have factors that would exclude DCD donation. Group characteristics are given in detail. SUMMARY: The attempt to measure donation potential was done at the Hospital of the Infant Jesus in Warsaw, a large, multispecialty hospital with intensive organ donation and transplantation programs. Results show a potential for DCD donation (54 potential donations over the last 4years), which allows us to create a quality system and algorithms for organ donation after circulation death.

Performance of the MDRD, CKD-EPI, and Cockcroft-Gault Formulas in Relation to Nutritional Status in Stable Renal Transplant Recipients.

BACKGROUND: Monitoring of the function of the implanted kidney in renal transplant recipients (RTRs) is one of the superior elements of adequate therapeutic actions. The aim of this study was to assess the conventional and unconventional factors affecting the estimated glomerular filtration rate (eGFR) with the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft-Gault (C-G) formulas among the RTRs. METHODS: The study included 144 RTRs (mean age 52 years). Clinical and laboratory data were analyzed; eGFR was calculated with MDRD, CKD-EPI, and C-G formulas. We compared the results with MDRD as a reference calculating the percentage of reclassifications of chronic kidney disease (CKD) stages. Nutritional status was assessed with a body composition analyzer, Tanita BC 418. RESULTS: Multivariable linear regression analysis with MDRD and CKD-EPI formula as a dependent variable retained the following independent predictors: hemoglobin (Hb) (B = .365; P = .000), and red blood cell distribution width (RDW) (B = -.191; P = .024). Analysis of variance showed the existence of statistically significant differences (all P for trend <.05) between the CKD-EPI, MDRD, and C-G equations within the total scope of eGFR results (51.2 ± 21.2 vs 47.5 ± 18.7 vs 55.6 ± 20.6, respectively) as well as in quartiles of eGFR. CONCLUSIONS: Our data indicate that (1) with a value of eGFR >60 mL/min/1.73 m(2), the MDRD formula shows values that are on average 11% lower than in the CKD-EPI and C-G formulas; (2) with a value of eGFR <60 mL/min/1.73 m(2), the MDRD and CKD-EPI formulas do not show statistically significant differences.