A Nationwide Global Strategy for Kidney Transplantation with Controlled Cardiac Death Donor (cDCD) Has Improved Global Results. Spanish Multicentre SENTRA-GEODAS Group.

J. Portoles,^1,2 M. Perez-Saez,^2,3 D. Janeiro,^1,2 E. Melilli,² N. Maruri Kareaga,² E. de Souza,² F. Llamas,² J. Espi,² P. Martin Moreno,² D. Navarro,² A. Sancho-Calabuig,² M. Rodriguez-Ferrero,² D. Hernandez,² J. Pascual.^2,3

¹Nephrology, Hospital Puerta de Hierro, Majadahonda, Spain
²GEODAS-SENTRA Public Health Research Net RedinRen16/009/009 RETYC ISCIII, Madrid, Spain
³Nephrology, Hospital del Mar, Barcelona, Spain

Meeting: 2017 American Transplant Congress

Abstract number: C28

Keywords: Donation, Graft survival, Kidney transplantation, Survival

Session Information

Session Name: Poster Session C: Deceased Donor Issues II: DCD, DGF, AKI, En-Bloc

Session Type: Poster Session

Date: Monday, May 1, 2017

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

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Background: Controlled donation after cardiac death (cDCD) programs are running in US for years and some European countries has recently started on it. National transplant organization (ONT) has developed a nationwide strategy in Spain from jan-2012 and 45 Centers had joined by Dec2015 (368 cDCD donors on 2012-15). Eighteen centers have entered our study group.

Methods: This is an observational prospective multicenter study with systematic inclusion in a shared database of every kidney transplant-KTx from cDCD.

Results: We included 275 cDCD, donors aged 56,9 years who have died mainly due to CV events (73%). Effective harvest rate was 91% higher than reported for uncontrolled DCD by ONT (67%) 16 kidneys were discharged for several reasons; his pairs were successfully implanted. 59 transferred and implanted in centers out of our group. We include 475 ESRD recipients: 56.5y, 68,2% males, for 74,6%of them were the first KTx .Immunosuppression regimen included 98,7% induction (Thymoglobulin 67,3%/ Basiliximab 31,5%) plus prednisone-MMF-Tacrolimus (83,1%) or mTOR (6,9%). Median Cold ischemia time (CIT) was 12,4h and warm IT 24min. Median HLA-mismatch was 4.

Clinical outcomes: Primary graft failure (PGF) rate was 3% mainly associated to vascular problems no any hyperacute rejection case. Delayed graft function (DGF) was defined as dialysis use on 1st week after KTx. In spite of DGF rate of 49,7% the death censored graft survival was 97,9% at 1 yr and92,2% at 2 yr.13 patient died with functional graft and patient survival was 95,3% (Kaplan-Meier).

Conclusions: Harvested graft rate for cDCD are higher than reported for uncontrolled DCD. KTx with cDCD present higher DGF than historic reference for brain death donor but similar PGF rate and patient or graft survival rates. cDCD programs has improved global KTx results and are good enough to promote it all over the country.

CITATION INFORMATION: Portoles J, Perez-Saez M, Janeiro D, Melilli E, Maruri Kareaga N, de Souza E, Llamas F, Espi J, Martin Moreno P, Navarro D, Sancho-Calabuig A, Rodriguez-Ferrero M, Hernandez D, Pascual J. A Nationwide Global Strategy for Kidney Transplantation with Controlled Cardiac Death Donor (cDCD) Has Improved Global Results. Spanish Multicentre SENTRA-GEODAS Group. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Portoles J, Perez-Saez M, Janeiro D, Melilli E, Kareaga NMaruri, Souza Ede, Llamas F, Espi J, Moreno PMartin, Navarro D, Sancho-Calabuig A, Rodriguez-Ferrero M, Hernandez D, Pascual J. A Nationwide Global Strategy for Kidney Transplantation with Controlled Cardiac Death Donor (cDCD) Has Improved Global Results. Spanish Multicentre SENTRA-GEODAS Group. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/a-nationwide-global-strategy-for-kidney-transplantation-with-controlled-cardiac-death-donor-cdcd-has-improved-global-results-spanish-multicentre-sentra-geodas-group/. Accessed November 21, 2024.

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