L. Hostert

Impact of the new fast track kidney allocation scheme for declined kidneys in the United Kingdom

A “new” fast track kidney allocation scheme (FTKAS) was implemented in the UK in 2012 for offering of previously declined kidneys. We evaluated the impact of the FTKAS in utilization of declined kidneys and outcome.

Renal Transplantation From Pediatric Donors in the United Kingdom.

Background Significant disparity exists in the United Kingdom between the need for organ transplant and supply of deceased donor organs. In the recent years, efforts to increase donation has improved the rate of mainly deceased donors after circulatory death and from older donors. The rate of donation from pediatric population has remained low and those younger than 2 years including neonatal donation has remained largely unexplored. Methods A retrospective review of the outcome of renal transplantation from pediatric donor (<18 years) kidneys in the United Kingdom. Results Our results show a poor referral and conversion rate, and high discard rate (43%) of kidneys procured from donors younger than 2 years. During the 15-year study period (1997–2011), 47 donors younger than 2 years were referred (3 per year). Of these, 26 proceeded to donation resulting in 17 transplants (65% utilization). The referral rate for donors 2 years or older to younger than 5 years also remains low (76 in 15 years), but the conversion (88%) and utilization rates (73%) are better in this group. There was better utilization in donors aged 5 years or older to younger than 18 years. Overall graft and patient survival remains excellent in all 3 groups; with comparable survival of 82%, 85%, and 77% (P = 0.29) with mean follow-up periods of 9, 12.5, and 11.8 years, respectively. Conclusions Despite excellent outcome, the referral, donation, and utilization of kidneys from donors younger than 5 years and particularly those younger than 2 years remain low. We suggest implementing improved strategies to increase donation from this group of population.

Transplantation of solid organs procured from influenza A H1N1 infected donors.

Following the influenza A H1N1 (swine flu) pandemic, there remains little evidence informing the safety of transplanting organs from donors suspected or diagnosed with H1N1. Limited guidelines from the major transplant societies leave the use of such organs at the discretion of individual transplant centres, and practice varies considerably both nationally and internationally. We present the largest published series of outcome following transplantation of organs from H1N1 positive donors and demonstrate that these organs can be transplanted safely and with good short‐term outcome. We discuss our local policy for treatment of recipients with Oseltamivir.

Complete Absence of Iliac Arteries in the Left Hemipelvis in a Case of Deceased Donor Renal Transplantation

Renal transplantation is an established method of treating end-stage renal failure. Whilst the majority of procedures follow a standard technique, vascular anomalies may pose intraoperative challenges and, therefore, careful preoperative assessment is warranted. We present a unique, complex case compounded by complete absence of iliac arteries in the left hemipelvis in association with double inferior vena cava in a young recipient.