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Similar Outcomes of Kidney Transplantations Using Organs From Donors After Cardiac Death and Donors After Brain Death
Y Nakamura1, Y Kihara1, T Yokoyama1
1Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
Insights
Cadaveric kidney transplants from brain death (DBD) and cardiac death (DCD) donors showed good outcomes. Standard criteria donors (SCD) offered better long-term renal function than expanded criteria donors (ECD), with no significant differences in survival rates.
Area of Science:
- Nephrology
- Transplant Surgery
- Organ Donation
Background:
- Increasing cadaveric kidney transplants in Japan requires utilizing all donor organs.
- Post-Organ Transplant Law revision, a decrease in donors after cardiac death (DCD) but an increase in donors after brain death (DBD) was observed.
- Despite shifts in donor types, the overall number of donor organs and awareness of cadaveric transplantation have risen.
Purpose of the Study:
- To evaluate the outcomes of cadaveric kidney transplantation from donors after brain death (DBD) and donors after cardiac death (DCD).
- To compare transplant outcomes between expanded criteria donors (ECD) and standard criteria donors (SCD).
Main Methods:
- A retrospective analysis of 28 cadaveric kidney transplant recipients from January 2001 to December 2016.
- Patients were categorized into DBD and DCD groups.
- Further classification based on donor type: 10 recipients from ECD and 18 from SCD.
Main Results:
- No significant difference in renal function at 6 months between DBD and DCD recipients.
- Expanded criteria donors (ECD) showed better renal function at 1, 3, and 5 years compared to standard criteria donors (SCD).
- Renal function at 5 years was significantly better in the standard criteria donor (SCD) group than the expanded criteria donor (ECD) group, with no difference in delayed graft function.
Conclusions:
- Cadaveric kidney transplantation yielded good results across all patient groups.
- No significant differences in transplant outcomes were observed between expanded criteria donors (ECD) and standard criteria donors (SCD).
Background:
To increase the number of cadaveric kidney transplants in Japan, it is necessary to proactively use organs from all donors. Since the revision of the Organ Transplant Law, the number of organ donors after cardiac death (DCD) has decreased but the number of organ donors after brain death (DBD) has increased; however, the number of donor organs and awareness of cadaveric transplantation have increased.
Methods:
At our institution, 28 patients underwent cadaveric kidney transplantation from January 2001 to December 2016. These patients were classified into 2 groups according to DBD or DCD. Furthermore, 10 patients received transplants from expanded criteria donors (ECD) and 18 received them from standard criteria donors (SCD).
Results:
Kidney graft survival and engraftment were observed for all patients. There were no significant differences in renal function at 6 months for DBD and DCD transplant recipients. Renal function at 1, 3, and 5 years and serum creatinine levels were better for the ECD group. Renal function at 5 years after transplantation was significantly better for the SCD group than for the ECD group; however, there was no difference in delayed graft function between the SCD and ECD groups. Comparisons of the 3 groups showed good renal function for transplants from DBDs, but there was no significant difference in survival rates.
Conclusions:
Results were good for all patients. There were no significant differences in outcomes of our patients who received transplants from ECD or SCD.
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