الاثنين 20 سبتمبر 2021 هـ | 20 سبتمبر 2021 م

General standards

The organs of the deceaseds donor are considered valid for transplantation except in the following cases:

  1. Damage as a result of the initial injury causing death or shock lasting for more than 30 minutes, except cases of tissue transplantation.
  2. Cancer in the deceased donor (documented or suspected), except in primary brain tumors confirmed by pathology and skin cancer (basal cell carcinoma).
  3. Idiopathic illness.
  4. Active and disseminated infection.
  5. Active infection with HIV.
  6. Active infection with hepatitis B or C viruses or HTLV virus. **
  7. Neurological diseases such as Reye’s syndrome or slow virus diseases such as Creutzfeldt-acob  disease, progressive multi- focal encephalopathy, rabies, or Kawasaki disease.
  8. Addiction to drugs.

Special criteria for kidney transplant from deceased.

The SCOT should be consulted in the following cases with extended criteria donors:

  1. Presence of  a  higher level of creatinine (2.5 mg/dL) in the deceased donors ,adequate fluid replacement. Note: The donor hospital should coordinate with the SCOTand also with the RCO, Thekidneyfromadeceaseddonorcanbeacceptedfortransplantationifhe/she has hepatitis B antigen  (Hbs Ag)  +ve and transplanted to patients with immunity against hepatitis B or C or carrying the antigen itself provided that they do not have active hepatitis and the decisionis made on a case by case basis in consultation with the SCOT.
  2. Presence of advanced chronic kidney disease and/or chronic arterial hypertension in the eceased donor in addition to donors affected by mild Diabetes or inactive systemic lupus erythematosis disease.
  3. If the age of the deceased donor below (2) or more than (50) years, or When the patient’s age is unknown.

Special criteria for heart transplantation.

The heart of the deceased donor is considered valid for transplantation except in  the following cases:

  1. If the donor has one of the problems mentioned under the general criteria.
  2. If the age of deceased donor is above 40 years for males, or above (50) Years for females and should consult with the SCOT in all cases.*
  3. If the condition of the heart was not normal, based on clinical examination, cardiac enzymes, electrical cardiac activity, chest  X-ray  and ultrasound examination.
  4. If the deceased donor had a previous severe chest trauma that caused damage to the heart.
  5. If the period of cold ischemia exceeds five hours.

*The heart could be considered fit for transplantation if investigations confirmed its normal condition.

Special criteria for the lung transplantation.

Lungs of deceased donor is considered valid for transplantation, except in the following cases:

  1. If the donor has one of the problems mentioned under general criteria.
  2. If the donor age exceeds 60 years. The SCOT should be consulted in all cases.
  3. If the past medical history of the donor reveals evidence of chronic  respiratory disease ,or he was a smoker over 20 pack- years ,or if he has had thoracic surgery knowing that a unilateral thoracic surgery does not affect the stability of the other lung ,or if he has had bronchial disease or recurrent respiratory infections.
  4. If the donor has had trauma that cause Injury to the lungs, exposure to toxic gases or fumes or aspiration of gastric contents.
  5. If the lungs were abnormal by clinical evaluation, X- ray chest and blood gases examination performed after putting the patient on FiO2 of 100% with PEEP of 5 cm water for 5 minutes show PaO2 < 300 mmHg.
  6. If the donor has purulent trachea bronchial secretions and Gram’s stain And possibly culture reveals pathologic organism.
  7. If there is size incompatibility between donor and recipient.

Special criteria for liver transplantation.*

The liver of the deceased donor is considered valid for transplantation,  except in the following cases:

  1. If the donor has one of the problems mentioned under general criteria.
  2. If his age exceeds 50 years.
  3. If his liver function tests are abnormal.
  4. If there is alcohol and / or drug addiction.

Indications for split liver transplantation.

  1. Age less than 45 years old.
  2. The level of serum sodium less than 160 mmol/L.
  3. ALT ratio of less than 3 times the normal value.
  4. AST ratio of less than 3 times the normal value.
  5. GGT ratio is less than twice the normal value.
  6. If there is no macroscopic liver trauma.
  7. Stable hemodynamic condition of the donor.
  8. Low to moderate administered dose of inotrops.
  9. Donor stay in intensive care less than 7 days.

*The SCOT should be consulted in all cases.

 Special criteria for the pancreatic transplantation.

The pancreas of deceased donor is considered valid for transplantation except in the following cases:

  1. The donor exceeds the age of 45 years.
  2. History of diabetes or alcohol addiction.
  3. Serum glucose >11mmol/L(200mg/dL).
  4. The body mass index (BMI) more than30.
  5. History of previous trauma or surgery of the pancreas.
  6. Active inflammation of the pancreas either (acute or chronic)and lipase serum level over 300IU/L.
  7. Prolonged hypotension or hypoxemia with end organ damage.
  8. The donor is on high doses of inotropic drugs.

Special criteria for bone transplantation.

The bones of the deceased donor is considered valid for transplantation except in  the following cases:

  1. The presence of an infectious disease that may be passed from one patient to another, such as: HIV ,and hepatitis B, hepatitis C, and others.
  2. Presence of certain diseases of the nervous system, especially brain Diseases such as Alzheimer’s, Parkinsons’s and others.
  3. Presence of certain types of diseases of the joints and bones.
  4. Presence of some types of cancer diseases.
  5. Direct damage of the donated bone.
  6. If the period between the cardiac arrest of the deceased donor and retrieval of bone was more than (12) hours.

Special criteria for corneal transplantation.

The cornea from deceased donor is considered valid for transplantation except in the following cases:

  1. If the donor has one of the problems mentioned under general criteria.
  2. If there is any disease of the eye such as a tumor , active conjunctivitis, any disease involving the corneas or iris, or if a  previous surgical procedure has been performed on the eye which has damaged the cornea.
  3. If he has congenital rubeola.
  4. If  the time between donor cardiac arrest and corneal harvesting exceeds 12 hours