*Purpose: Donors of circulatory death (DCD) have similar outcomes compared to donors of brain death (DBD) in kidney transplants. It is unclear if this is also true across KDPI range.

*Methods: Data from UNOS/OPTN as of 05/2018 was used to examine DCD vs. DBD outcomes across the KDPI. Deceased donor adult recipients from 2015-18 (n=38,780) were stratified in DCD(n=8,207) and DBD (30,572). Primary non-function (PNF), delayed graft function (DGF), 3-year death censored graft failure (DCGF) and patient death (PD) were examined using percentages, adjusted logistic and cox regression.

*Results: Groups differed in all demographic and transplant baseline characteristics. PNF and DGF risk were increased in DCD vs. DBD, odds ratio (OR) 1.19(95%CI,1.11-1.28) and 3.23(3.04-3.44); while DCGF and PD risk were similar, hazard ratio (HR) 0.97(0.84-1.11) and 0.96(0.84-1.09), respectively. In DBD the prevalence of DGF increased the highest the KDPI, and in DCD it seems to plateau around 50% with KDPI > 70% (figure 1 – graphs). OR to DGF varied from 2.2-2.6 and HR to DCGF was not significant different in DCD vs. DBD across KDPI intervals (table 1). A sub-analysis compared DCD groups stratified by KDPI < or > 85%, and DGF (table 2).

*Conclusions: DCD compared to DBD was associated with increased risk of DGF, but similar 3-year DCGF. A higher KDPI did not modify DGF and DCGF risks when comparing DCD vs. DBD. DGF increased risk of DCGF in DCD transplants independent of KDPI.

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