Donor characteristics associated with reduced survival of transplanted kidney grafts in Korea

Certain donor characteristics are known to be associated with increased graft failure in kidney transplantation.

We analyzed donor and recipient characteristics among deceased donor kidney transplantations performed from 1995 to 2008, excluding multiorgan, pediatric, and retransplantation cases.

The 299 cases underwent analysis of donor characteristics including age, sex, cause of brain death, history of hypertension, cardiac arrest, length of intensive care unit (ICU) stay, last serum creatinine before organ donation, and change in creatinine during ICU stay. Cox regression analysis identified two factors that independently predicted a greater risk of graft failure. The factors were cerebrovascular accident (CVA) as the cause of brain death and a history of hypertension. Compared with donors with causes of brain death other than CVA, the adjusted hazard ratios for graft failure (GF) of kidneys from donors with CVA were 2.37 (1.34-4.19, P=.003). The hazard ratio for GF was 2.42 (1.34-4.37, P=.003) for kidneys from those with a history of hypertension. Donors meeting the criteria of CVA as the cause of brain death or history of hypertension comprised 43% of transplantation cases (128/299). Donor age and last serum creatinine level, which were identified in previous studies to show higher risks of graft failure, did not apply in our patients.

Donor history of hypertension and CVA as the cause of brain death were significant determinants of reduced graft survival after DDKT in Korea.