Survival Outcomes from DCD Transplant Are Comparable to DBD Transplant from Kidneys Procured from Donors > 50 Years of Age. A UNOS/OPTN Propensity Score Matched Pair Analysis.
Multi-Organ Transplant Unit, London Health Sciences Centre, London, ON, Canada
Meeting: 2017 American Transplant Congress
Abstract number: 266
Keywords: Kidney transplantation, Risk factors, Survival
Session Information
Session Name: Concurrent Session: Long Term Kidney Graft Survival I
Session Type: Concurrent Session
Date: Monday, May 1, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:30pm-3:42pm
Location: E450a
Background:
Caution is guarded in accepting offers from old donors due to risk of poor graft function. We aim to present the factors significantly determining the short /long term graft & patient survival in DCD & DBD transplants from kidneys procured from donors > 50-year age.
Methods:
14288 cadaveric kidney transplants (1833 DCD & 13533 DBD) from donors > 50 years with <10% missing data reported to UNOS during 2008 – 2013 were data mined.
Propensity scores (PS) for survival analyses were estimated by logistic regression based on the age/BMI of donor/recipient, CIT & KDRI Rao. 3:1 matched pairs (1833DCD & 7022 DBD) based on the PS with calliper of 20% of SD were extracted.
Survival estimation was done by multivariate regression and Cox regression models.
Results: No statistical difference in patient and death censored graft survival rate at 1, 3 and 5 years in both DCD & DBD transplant patients (Patient survival – DCD- 90%,82%,70%; DBD 91%, 82%, 72% p=0.37), (Death censored graft survival – DCD- 90%,84%,76%; DBD 92%, 85%, 77% p=0.47).
Dialysis in 1st week of transplant p=<0.02, rejection within 6 months of transplant p<0.001, high KDRI p=0.04, recipient BMI >30- p< 0.006, were independent markers of poor patient/graft survival in both groups. H/O recipient HTN and smoking p=0.01, 0.03) were associated with inferior patient survival >3-year post-transplant in both groups.
On sub group analysis, donors > 70 years were associated with inferior patient & graft survival in both groups of transplants.
Conclusions:
We emphatically report that there are comparable results from both DCD & DBD renal transplants from donors > 50 years. In an acceptable donor, recipient factors play a more important role for graft and patient survival.
CITATION INFORMATION: Sharma H, Mikhail D, Chen J, Al-Harbi B, Luke P, Sener A. Survival Outcomes from DCD Transplant Are Comparable to DBD Transplant from Kidneys Procured from Donors > 50 Years of Age. A UNOS/OPTN Propensity Score Matched Pair Analysis. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Sharma H, Mikhail D, Chen J, Al-Harbi B, Luke P, Sener A. Survival Outcomes from DCD Transplant Are Comparable to DBD Transplant from Kidneys Procured from Donors > 50 Years of Age. A UNOS/OPTN Propensity Score Matched Pair Analysis. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/survival-outcomes-from-dcd-transplant-are-comparable-to-dbd-transplant-from-kidneys-procured-from-donors-50-years-of-age-a-unosoptn-propensity-score-matched-pair-analysis/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress