Donor Age Is the Most Important Predictor of Longterm Graft Function in Simultaneous Pancreas-Kidney Transplantation from Donors After Cardiac Death.

J. Chen,¹ D. Mikhail,^1,2 H. Sharma,³ A. Hijazi,¹ D. Nap,¹ L. Stitt,⁴ J. Jevnikar,⁵ M. Cooper,⁶ P. Luke,^1,2 A. Sener.^1,2

¹Schulich School of Medicine and Dentistry, London, Canada
²Division of Urology, Department of Surgery, Western University, London, London, Canada
³Division of General Surgery, Department of Urology, Western University, London, Canada
⁴LW Stitt Statistical Services, London, Canada
⁵Faculty of Engineering and Architectural Sciences, Ryerson University, Toronto, Canada
⁶Georgetown University, Washington

Meeting: 2017 American Transplant Congress

Abstract number: 490

Keywords: Age factors, Donors, Graft survival, Kidney/pancreas transplantation, non-heart-beating

Session Information

Session Name: Concurrent Session: DCD and Infectious Risk Kidney Donors

Session Type: Concurrent Session

Date: Tuesday, May 2, 2017

Session Time: 4:30pm-6:00pm

Presentation Time: 4:54pm-5:06pm

Location: E450b

STUDY PURPOSE: We analyzed data from UNOS to determine the effects of donor age, donor BMI, and organ cold ischemic time on DCD-SPK graft outcomes.

METHODS: We evaluated all DCD-SPK transplants performed in the United States from 1988 to 2013. We excluded transplants with incomplete values required to calculate pancreas and kidney donor risk indices (PDRI and KDRI). The effects of donor characteristics on graft and recipient survival were evaluated using Cox Regression and the Kaplan-Meier method. Logistic regression was used to evaluate effects on delayed graft function (DGF).

RESULTS: We analyzed 189 DCD transplants with donors ≤40 years old, and 38 with donors >40. Overall, SPK grafts from donors >40 displayed significantly higher rates of kidney failure (HR 2.1, 95%CI 1.15-3.83, p<0.05) and pancreas failure (HR 2.07, 95%CI 1.16-3.70, p<0.05) compared to grafts from donors ≤40. One year (88.2% ± 2.4% vs 73.4% ± 7.2%) and 10 year (66.3% ± 6.9% vs 50.3% ± 10%) pancreas survival was greater in donors ≤40. A similar trend was observed for short and longterm kidney graft survival. Importantly, increasing donor age was associated with increased DGF (OR 1.030, 95%CI 1.003-1.057, p<0.05). Increasing donor BMI was also predictive of pancreas failure (HR 1.024, 95% CI 1.007-1.042, p<0.01), recipient mortality (HR 1.022, 95% CI 1.003-1.041, p<0.05), and DGF (OR1.119, 95%CI, 1.035-1.208, p<.005). Donor age was equally as predictive of 1 year graft outcomes as PDRI or KDRI. We did not observe an effect of cold ischemic time on graft outcomes.

CONCLUSIONS: Donor age and donor BMI are significant predictors of DCD-SPK graft failure, DGF, and recipient mortality. Organs from donors >40 are twice as likely to result in kidney failure and pancreas failure compared to grafts from donors ≤40.

CITATION INFORMATION: Chen J, Mikhail D, Sharma H, Hijazi A, Nap D, Stitt L, Jevnikar J, Cooper M, Luke P, Sener A. Donor Age Is the Most Important Predictor of Longterm Graft Function in Simultaneous Pancreas-Kidney Transplantation from Donors After Cardiac Death. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Chen J, Mikhail D, Sharma H, Hijazi A, Nap D, Stitt L, Jevnikar J, Cooper M, Luke P, Sener A. Donor Age Is the Most Important Predictor of Longterm Graft Function in Simultaneous Pancreas-Kidney Transplantation from Donors After Cardiac Death. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/donor-age-is-the-most-important-predictor-of-longterm-graft-function-in-simultaneous-pancreas-kidney-transplantation-from-donors-after-cardiac-death/. Accessed November 22, 2024.

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