MP52-02 INITIAL EXPERIENCE WITH RENAL TRANSPLANTS AFTER MEDICAL ASSISTANCE IN DYING: FIRST SERIES IN NORTH AMERICA

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery II (MP52)1 Apr 2020MP52-02 INITIAL EXPERIENCE WITH RENAL TRANSPLANTS AFTER MEDICAL ASSISTANCE IN DYING: FIRST SERIES IN NORTH AMERICA Samir Sami*, Max Levine, Andrew Rasmussen, Alp Sener, and Patrick Luke Samir Sami*Samir Sami* More articles by this author , Max LevineMax Levine More articles by this author , Andrew RasmussenAndrew Rasmussen More articles by this author , Alp SenerAlp Sener More articles by this author , and Patrick LukePatrick Luke More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000914.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In 2016, Canadian federal legislation was passed creating a regulatory framework for medical assistance in dying (MAiD) for individuals who were suffering from a medically futile condition and foreseeable death. As there is a paucity of literature on transplantation from MAiD donors, we report our unique experience and first reported outcomes in North America. METHODS: We retrospectively analyzed all renal transplant recipients from MAiD donors at London Health Sciences Centre, beginning in 2018. Patients eligible for MAiD underwent circulatory death after administration of life ending therapy and organ procurement was performed as per standard protocol. Ethics approval was obtained to review these outcomes. RESULTS: There were a total of 4 patients who became kidney donors and one kidney-pancreas donor. The indication for MAiD in the donors included 3 with debilitating neurological disease, 1 with heart failure and 1 who previously suffered a significant fall resulting in quadriplegia. Mean donor age was 53.66 ±13.17, median warm ischemia time (WIT) was 17 minutes, and median cold ischemia time (CIT) was 9 hours. One perioperative death occurred due to medical complication unrelated to renal graft function. No delayed graft function was encountered and only two patients experienced slow graft function. Median 30 day creatinine was 108 μmol. CONCLUSIONS: MAiD associated organ donation represents a potential means to increase the donor pool for those awaiting deceased donor organs. The controlled nature of MAiD associated circulatory death has the potential to minimize the deleterious effects of prolonged WIT that may be associated with standard donation after circulatory death. Our institution’s early experience is encouraging, with low WIT, and favorable early graft function results. Ongoing assessment of MAiD outcomes is required to better quantify the quality of these donation opportunities compared to conventional deceased donors. Source of Funding: N/A © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e772-e772 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samir Sami* More articles by this author Max Levine More articles by this author Andrew Rasmussen More articles by this author Alp Sener More articles by this author Patrick Luke More articles by this author Expand All Advertisement PDF downloadLoading ...