Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Controlled donation after cardiac death (cDCD) programs are running in several countries for years. National transplant organization (ONT) has developed a nation-wide program in Spain from 2012 and 40 Centers had
started by Aug15 (415 cDCD Kidney transplants-KTx from Jan12 to Aug15). Thirteen centers have joined this study group. We present our preliminary analysis.
Methods: Observational prospective multicentre study. Systematic inclusion of every KTx from cDCD at joined units. Local center surgical procedures and IS protocols.
Results: We included 246 cDCD KTx from 139 donors: 57.1 years, 64.8%male died mainly due to CV causes, Cr 0.7mg/dl. Seven kidneys were discharged for several reasons and 19 transferred and implanted in other centers.246 recipients:54.9y, 69.3%males 78,2% from HD, 17,3% DP, 8,8% preemptive; 89.5% 1st KTx, 9.7% 2nd, 0.8% 3rd. Cold ischemia time (CIT): 11h; median warm IT 24min, HLA-mismatch: 4 [0-5].Immunosuppression: 98,8% induction (Thymoglobulin 67,3% / Basiliximab 31,5%) plus prednisone-MMF-Tacrolimus (83,1%) or mTOR (6,9%). Mean follow-up: 14 [3-48] months.
Graft Function: Primary graft failure (PGF): 3%, delayed graft function (DGF):47,8%, Nadir Cr: 1.3 mg/dl [0,6-3,1]. Best eGFR (MDRD-4) 54.9 (23.4)ml/min. 1st year serum Cr 1.6 [0.9 – 4.8] 2nd year Cr 1.5 mg/dl [0.7- 4.9].
Final end-points: Patient survival was 95.5% at 2yr (8 patients died with functioning graft: 6 CV, 2 sepsis). Death censored graft survival was 91.5% at 2 yr (14 graft failures with return to dialysis).
The probability to reach 1st year eGFR>50 ml/min after the first cDCD KTx was associated to a lower donor age (OR1,1 per year) a shorter CIT (1,04 per hour) immediate function (4,2) or type of induction (Timoglobuline vs Basiliximab OR2,9) but not to HLA mismatches, previous dialysis or recipient age.
Conclusions: KTx with cDCD present higher DGF than historic reference for brain death donor but similar PGF rate and patient or graft survival rates. Our results aim us to promote this cDCD all over the country.
CITATION INFORMATION: Portoles J, Perez-Saez M, Hernandez-Marrero D, Lafuente O, Diekmann F, Maruri Kareaga N, Rodriguez-Ferrero M, Llamas F, Mazuecos M, Juega J, Melilli E, Rodriguez-Benot A, Alonso A, Pascual J. Controlled Cardiac Death Donor Program for Kidney Transplantation – Spanish Multicenter Experience with Two Years of Follow-Up. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Portoles J, Perez-Saez M, Hernandez-Marrero D, Lafuente O, Diekmann F, Kareaga NMaruri, Rodriguez-Ferrero M, Llamas F, Mazuecos M, Juega J, Melilli E, Rodriguez-Benot A, Alonso A, Pascual J. Controlled Cardiac Death Donor Program for Kidney Transplantation – Spanish Multicenter Experience with Two Years of Follow-Up. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/controlled-cardiac-death-donor-program-for-kidney-transplantation-spanish-multicenter-experience-with-two-years-of-follow-up/. Accessed August 25, 2019.
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