The development and outcomes of organ transplantation from donation after circulatory death in Taiwan

Background

It is imperative to increase the donor pool due to a persistent shortfall of organs for transplantation. Therefore, organ donation after circulatory death (DCD) was reintroduced in Taiwan in 2017, and has become a rightful source for kidney and liver transplantation. We aim to report the preliminary outcomes of organ transplantation from DCD donors in Taiwan.

Methods

All data of 48 DCD donors and consecutively 106 grafts were obtained from the registry of Taiwan Organ Registry and Sharing Center. Kidney and liver transplantations were performed between Jan 5th, 2018 and Sep 24th, 2021. The primary endpoints were recipient survival and graft survival by using Kaplan-Meier method.

Results

Overall, DCD donors accounted for 9.6% (48/501) of all deceased donors in Taiwan from 2017 to 2021. The recipient survival for 3-month, 1-year, and 3-year were 99, 94, and 94% for DCD kidney transplants; 86, 76 and 76% for DCD liver transplants. The 3-month and three-year kidney graft survival (censored for death) reached 95% and 94%, respectively; while liver graft survival (censored for death) reached 95% and 89%, respectively.

Conclusions

Transplantations from DCD donors showed satisfactory graft and recipient survivals in both kidney and liver transplants. Both kidney and liver transplantation from potential DCD donors should be advocated for its comparable outcomes to organs from brain-dead deceased donors.