Comparison of Kidney Transplantation Outcomes Between Donors After Controlled Circulatory Death and Brain Death Donors in Catalonia, Spain

J. Juega¹, M. Pérez-Sáez², J. Comas³, A. Zapatero⁴, M. Crespo², J. Tort³, R. Lauzurica¹, J. Pascual²

¹Nephrology, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain, ²Nephrology, Hospital del Mar, Barcelona, Spain, ³Departament de Salut, Organització Catalana de Trasplantaments (OCATT), Barcelona, Spain, ⁴Intensive care unit, Hospital del Mar, Barcelona, Spain

Meeting: 2021 American Transplant Congress

Abstract number: 844

Keywords: Brain death, Donors, non-heart-beating, Graft survival, Survival

Topic: Clinical Science » Kidney » Kidney Deceased Donor Selection

Session Information

Session Name: Kidney Deceased Donor Selection

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: The number of kidney transplants (KT) from controlled cardiac death donors (cDCD) has exponentially increased in Spain during the last years. Results from cDCD KT have been reported to be comparable to brain-death donors (DBD) KT in countries with long tradition of retrieving organs from cDCD. No studies have compared KT outcomes between these two types of donors in Spain, being this the main purpose of our study.

*Methods: Observational retrospective analysis including 1658 KT from DBD and 645 KT from cDCD, performed from January 2013 to December 2018 in Catalonia, Spain. Data were obtained from the Catalonian Registry of Renal Patients (RMRC) including donors, recipients and process of donation-transplantation. Median follow-up after KT was 26 months. A multivariate analysis was performed to identify risk factors for graft loss.

*Results: Both donors and recipients mean ages were significantly higher in the cDCD group compared to DBD group. (62 ± 13 vs. 58 ± 17 for donors, p<0,001; 60 ± 12 vs. 56 ± 15 for recipients, p <0,001). Incidence of delayed graft function (DGF) was higher in cDCD KT group (37.2% vs 21.6%, p<0.001) without differences in primary non-function rates (1.7% vs 0.8%, p=0.13). Renal function at 20 months was slightly better in DBD group (eGFR 52.4 ml/min vs 47.1 ml/min, p=0.001). At 3 years post KT no differences in death-censored graft survival were observed (91.2 vs. 91.3%). However, patient survival at 3 years was worse in cDCD group ( 85.3 vs. 89.3%). In multivariate analysis, recipient age >75 yr, previous cardiovascular disease and DGF were independent risk factors for patient death (RR 10.4, 2.28 and 1.8 respectively). Regarding graft survival ( death censored), Donor Age > 75 (RR 2.76), DGF (RR 1.85) and cPRA>50% (1.57) increased graft loss. The type of donation (cDCD vs DBD) was not an independent risk factor neither for patient survival nor graft loss.

*Conclusions: In a contemporary recent cohort, graft survival from both cDCD and DBD donors is comparable. Patient survival was lower in cDCD group independently from type of donation, finding recipient age >75 years, DGF and previous CV disease as risk factors pfor patient death. Risk factors for graft loss were cPRA>50%, donor age > 75 and DGF.

To cite this abstract in AMA style:

Juega J, Pérez-Sáez M, Comas J, Zapatero A, Crespo M, Tort J, Lauzurica R, Pascual J. Comparison of Kidney Transplantation Outcomes Between Donors After Controlled Circulatory Death and Brain Death Donors in Catalonia, Spain [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-kidney-transplantation-outcomes-between-donors-after-controlled-circulatory-death-and-brain-death-donors-in-catalonia-spain/. Accessed May 30, 2025.

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