Kidney transplantation from donation after cardiac death donors: lack of impact of delayed graft function on post-transplant outcomes
Version of Record online: 19 MAR 2010
© 2010 John Wiley & Sons A/S
Volume 25, Issue 2, pages 255–264, March/April 2011
How to Cite
Singh, R. P., Farney, A. C., Rogers, J., Zuckerman, J., Reeves-Daniel, A., Hartmann, E., Iskandar, S., Adams, P. and Stratta, R. J. (2011), Kidney transplantation from donation after cardiac death donors: lack of impact of delayed graft function on post-transplant outcomes. Clinical Transplantation, 25: 255–264. doi: 10.1111/j.1399-0012.2010.01241.x
- Issue online: 19 MAR 2010
- Version of Record online: 19 MAR 2010
- Accepted for publication 21 January 2010
- delayed graft function;
- donation after brain death;
- donation after cardiac death;
- expanded criteria donor;
- kidney transplantation;
- standard criteria donor;
- warm ischemia
Singh RP, Farney AC, Rogers J, Zuckerman J, Reeves-Daniel A, Hartmann E, Iskandar S, Adams P, Stratta RJ. Kidney transplantation from donation after cardiac death donors: lack of impact of delayed graft function on post-transplant outcomes. Clin Transplant 2011: 25: 255–264. © 2010 John Wiley & Sons A/S.
Abstract: Introduction: Delayed graft function (DGF) is more common in recipients of kidney transplants from donation after cardiac death (DCD) donors compared to donation after brain death (DBD) donors.
Methods: Single-center retrospective study to evaluate the impact of DGF on controlled (Maastricht category III) DCD donor kidney transplant outcomes.
Results: From 10/01 to 6/08, 578 adult deceased donor kidney transplants were performed including 70 (12%) from DCD and 508 (88%) from DBD donors. Mean follow-up was 36 months. DCD donor kidney transplants had significantly greater rates of DGF (57% DCD vs. 21% DBD, p < 0.0001)) and acute rejection (29% DCD vs. 16% DBD, p = 0.018) compared to DBD donor kidney transplants, but patient and graft survival rates were similar. DBD donor kidney transplants with DGF (n = 109) had significantly greater rates of death-censored graft loss (12.5% DCD vs. 31% DBD), primary non-function (0 DCD vs. 10% DBD) and higher 2 year mean serum creatinine levels (1.4 DCD vs. 2.7 mg/dL DBD) compared to DCD donor kidney transplants with DGF (n = 40, all p < 0.04). On univariate analysis, the presence of acute rejection and older donor age were the only significant risk factors for death-censored graft loss in DCD donor kidney transplants, whereas DGF was not a risk factor.
Conclusion: Despite higher rates of DGF and acute rejection in DCD donor kidney transplants, subsequent outcomes in DCD donor kidney transplants with DGF are better than in DBD donor kidney transplants experiencing DGF, and similar to outcomes in DCD donor kidney transplants without DGF.