Status:
Ready to upload
Record number:
1676
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Rare. Of 9014 kidneys retrieved over a 5-yr time period, 96 (1.06%) could not be transplanted because of damage sustained at procurement. Any damage was reported in 1726 (19%) kidneys but not all injury led to kidney discard.
Time to detection:
Immediately at procurement or upon receipt of the kidney at a transplant centre.
Alerting signals, symptoms, evidence of occurrence:
62% of the damaged organs were from donors aged 40 years or older. Donors’ age had a significant effect on both 1-year and 3-year transplant survival but kidney damage did not. Kidneys with vascular damage were no more likely to be unsuitable for transplantation than those with non-vascular damage. There was a significant difference in the proportion of kidney damage reported in kidneys retrieved by the three groups of centres based on activity. The lowest proportion of damaged kidneys were reported by centres with more than 50 retrievals per year. Such data lend weight to the opinion that more centralised multiorgan retrieval units encompassing large populations may decrease the risk of kidney damage and allow use of the maximum number of organs.
Demonstration of imputability or root cause:
Despite the high rate of damage to kidneys at procurement, most of the organs can be transplanted with no adverse effect on transplant survival. Kidney damage is least likely to occur with kidneys from young donors, and when liver teams or centres that undertake more than 50 procurements per year.
Groups audience:
References:
Suggest new keywords:
organ procurement, kidney, damage, injury
Reference attachment:
Suggest references:
Wigmore, S., Seeney, F., M., Pleass, H., Praseedom, R.,K., Forsythe, J. (1999). Kidney damage during organ retrieval data from UK National DataBase. The Lancet 354: 1143-46
Expert comments for publication:
Ensuring there is an adequately skilled surgical team available for procurement is vital to improving the utilization of kidneys.