Post-Kidney Transplantation Results After Circulatory or Brain Death Without Pre-Mortem Heparin Administration

Area of Science:

• Nephrology
• Transplantation Surgery
• Organ Donation

Background:

• Donation after circulatory death (DCD) and donation after brain death (DBD) are primary sources for kidney grafts.
• This study focuses on DCD and DBD kidney transplantation outcomes without pre-mortem heparin administration.
• Understanding long-term outcomes is crucial for optimizing organ utilization and patient care.

Purpose of the Study:

• To compare the 5-year post-transplantation outcomes of kidney recipients from DCD versus DBD donors.
• To evaluate graft survival and patient survival in DCD and DBD kidney transplantation cohorts.
• To assess the impact of donor type on transplantation success without pre-mortem heparin.

Main Methods:

• Retrospective cohort study analyzing 99 recipients and 94 matched donors from a single center (2015-2019).
• Comparison of cold ischemia duration and preservation solution perfusion times between DBD and DCD grafts.
• Analysis of 1-year and 3-year patient survival rates for both DBD and DCD kidney transplant recipients.

Main Results:

• DBD grafts had significantly shorter cold ischemia and preservation solution perfusion times compared to DCD grafts.
• 1-year survival rates were 97.5% for DBD and 90.0% for DCD recipients.
• 3-year survival rates were 91.9% for DBD and 90.0% for DCD recipients, with no statistically significant difference in overall survival or disease-free survival between groups (P=0.750 and P=0.370, respectively).

Conclusions:

• Kidney transplantation from DCD and DBD donors without pre-mortem heparin administration yields similar 5-year patient survival.
• The study indicates comparable long-term graft failure rates between DCD and DBD kidney transplants.
• These findings support the use of DCD donors as a viable option for kidney transplantation, achieving outcomes similar to DBD donors.