ID:181 FC-NP2-9 Outcomes of Kidney Transplantation from ECMO-Supported Brain-Dead Donors: A Single- Center Experience

Background: In South Korea, extracorporeal membrane oxygenation (ECMO) has been increasingly used in brain-dead donors to maintain organ perfusion and optimize organ utilization prior to procurement.However, the utilization rate of organs–particularly kidneys–from ECMO-supported donors and the clinical outcomes of recipients remain insufficiently described. This study aimed to describe the baseline characteristics of ECMO-supported brain-dead donors whose kidneys were utilized for transplantation and to evaluate the early postoperative outcomes of kidney transplant recipients who received grafts from these donors. Methods: We retrospectively reviewed donors who received ECMO support prior to organ procurement at our institution between 2013 and 2024. Donor demographic characteristics and ECMO-related parameters were analyzed. All kidneys procured from these donors were transplanted at our center. Recipient preoperative characteristics, intraoperative findings, and postoperative outcomes up to 1 year after transplantation were also evaluated. Results: Among 190 donors after brain death, 16 donors (8.4%) required ECMO support prior to organ procurement. Of these, kidneys from 11 donors were transplanted into recipients at our institution. One-year graft survival and recipient survival were both 100%. Conclusion: ECMO support in brain-dead donors prior to organ procurement may facilitate successful kidney transplantation. Recipients who received kidneys from ECMO-supported donors demonstrated satisfactory early postoperative outcomes.