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The evolution of donation after circulatory death renal transplantation: a decade of experience

Richard Bell1, Shahid Farid1, Sanjay Pandanaboyana1,2

  • 1Department of Hepatobiliary and Transplant Surgery, Grafton, Auckland, New Zealand.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|June 30, 2018
PubMed

Insights

Kidney transplants from donation after circulatory death (DCD) donors show comparable long-term survival and function to those from donation after brain death (DBD) donors. Extended criteria DCD grafts offer benefits over dialysis for selected patients.

Area of Science:

  • Nephrology
  • Transplantation Surgery
  • Organ Donation

Background:

  • Comparing long-term outcomes of renal transplantation using donors after circulatory death (DCD) versus donation after brain death (DBD).
  • Study conducted at a major UK transplant center.
  • Analysis of deceased donor kidney transplants between 2002 and 2014.

Purpose of the Study:

  • To compare graft survival (GS) and patient survival (PS) between DCD and DBD kidney donors.
  • To evaluate outcomes based on standard criteria donors (SCD) and extended criteria donors (ECD).
  • To identify risk factors affecting graft function and survival.

Main Methods:

  • Retrospective analysis of 468 DCD and 905 DBD renal transplants.
  • Comparison of GS and PS up to 10 years post-transplantation.
  • Assessment of graft function at 3 months and identification of risk factors for delayed graft function and reduced survival.

Main Results:

  • Comparable GS (61% vs 55%) and PS (78% vs 71%) between DCD and DBD donors up to 10 years.
  • Worse GS and function in ECD groups, with no difference between EC-DBD and EC-DCD.
  • DCD donors identified as a risk factor for delayed graft function; post-operative complications and EC-DCD donation linked to reduced GS and PS.

Conclusions:

  • DCD renal grafts demonstrate comparable long-term survival and function to DBD grafts.
  • Use of extended criteria DCD (EC-DCD) grafts is viable for selected recipients, offering advantages over dialysis.
  • Findings support the expanded use of DCD donors in renal transplantation.
Abstract

Keywords:
DCDdonorextended criteriaoutcomerenal transplant

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