Kidney transplantation from donors without a heartbeat

Area of Science:

• Nephrology
• Transplantation Immunology
• Organ Donation

Background:

• Addressing critical kidney donor shortages necessitates exploring alternative organ sources, including deceased donors after circulatory death (DCD) without a heartbeat.
• Previous studies suggest comparable short-term survival for DCD kidneys, but large-scale, long-term data remain limited.

Purpose of the Study:

• To compare the long-term outcomes of kidney transplants from donors without a heartbeat versus donors with a heartbeat in a matched cohort.

Main Methods:

• A single-center, matched study comparing 122 kidney transplantations from donors without a heartbeat with 122 from donors with a heartbeat (1985-2000).
• Recipients were matched for age, sex, transplantation history, and calendar period.

Main Results:

• A higher incidence of delayed graft function was observed in recipients of kidneys from donors without a heartbeat (48.4%) compared to donors with a heartbeat (23.8%).
• Long-term graft survival rates at 10 years were similar between the two groups: 78.7% for donors without a heartbeat and 76.7% for donors with a heartbeat (P=0.98).

Conclusions:

• Kidneys from donors without a heartbeat are a viable option for transplantation, demonstrating equivalent long-term graft survival despite a higher initial rate of delayed graft function.
• This study supports the expanded use of DCD kidneys to mitigate organ scarcity without compromising long-term transplant success.