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Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?

T. Zens, G. Leverson, R. Redfield, P. Chlebeck, L. Zitur, D. Kaufman, L. Fernandez.

Surgery, University of Wisconsin, Madison, WI.

Meeting: 2016 American Transplant Congress

Abstract number: B188

Keywords: Donors, Graft failure, Graft function, Outcome, unrelated

Session Information

Session Name: Poster Session B: Kidney Transplantation: KDPI, HCV/Matching, Donor Age

Session Type: Poster Session

Date: Sunday, June 12, 2016

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Introduction: Renal transplant outcomes are a result of a combination of donor and recipient factors. In 2014, the nomenclature used to describe donor quality was changed from extended criteria versus standard criteria to kidney donor profile index (KDPI). The aim of our study is to characterize differences in transplant outcomes for donor after cardiac death (DCD) and donor after brain death (DBD) transplants with similar KDPIs.

Methods: An single center retrospective chart review was performed from 1/1999-7/2013. 2161 kidney transplants were included. The patients were divided into 6 groups: DBD KDPI≤60, DBD KPDI 61-84, DBD KDPI≥85, DCD KDPI≤60, DCD KPDI 61-84, and DCD KDPI≥85. Rates of DGF, patient survival, and graft survival were examined.

Results: When examining all groups, rates of DGF increased with increasing KDPI and graft and patient survival decreased with increasing KDPI (p value <0.001). DCD kidneys had substantially higher rates of DGF than their DBD counterparts. There were no statistically significant differences between patient or graft survival when comparing DCD and DBD kidneys with equivalent KDPIs.

 

DBD

KDPI 0-60

N=1118

DCD

KDPI 0-60

N=328

P value
DGF 18.7% 45.1% <0.001
Graft Survival at 5 yrs 74.6%  77.7%

0.3170

Patient Survival at 5 yrs 85.8% 86.4%

0.6044

 

DBD

KDPI 61-84

N=384

DCD

KDPI 61-84

N=163

P value
DGF 29% 49.1% <0.001
Graft Survival at 5 yrs 62.7% 61.1%

0.9817

Patient Survival at 5 yrs 76.3% 75.0%

0.8178

 

DBD

KDPI ≥ 85

N=130

DCD

KDPI ≥ 85

N=38

P value
DGF 31.5% 55.3% 0.007
Graft Survival at 5 yrs 48.6% 54.2% 0.4079
Patient Survival at 5 yrs 63.4% 59.5% 0.9865

Conclusion: Increasing KDPI is a more powerful predictor of patient or graft survival than DCD versus DBD status given there are no differences between DBD and DCD kidneys with similar KDPIs. DCD status is the strongest factor contributing to the development of DGF. The new KDPI system is an accurate predictor of donor contributions to transplant outcomes as rates of DGF and graft failure increase with increasing KDPI in all patients.

CITATION INFORMATION: Zens T, Leverson G, Redfield R, Chlebeck P, Zitur L, Kaufman D, Fernandez L. Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI? Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Zens T, Leverson G, Redfield R, Chlebeck P, Zitur L, Kaufman D, Fernandez L. Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/is-there-a-difference-between-dcd-and-dbd-kidney-transplantation-with-similar-kdpi/. Accessed May 24, 2025.

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