Delayed Graft Function (DGF) Doesn't Affect Adversely the Long-Term Survival of Renal Transplantations (RT) from Uncontrolled Donation After Cardiac Death (UDCD) as Compared with RT from Standard Criteria Donor (SCD).
1Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
2Nephrology, Hospital de Clínicas, Montevideo, Uruguay.
Meeting: 2016 American Transplant Congress
Abstract number: C191
Keywords: Brain death, Donors, non-heart-beating, Survival
Session Information
Date: Monday, June 13, 2016
Session Name: Poster Session C: Kidney Transplantation: AKI/Preservation/DCD
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
INTRODUCTION: DGF is a well-known risk factor for long-term kidney survival in RT. DGF hasn't been evaluated in RT from SCD and from UDCD donors.
AIM: To identify factors associated with 5 years renal graft survival in RT in UDCD donors and SCD.
MATERIAL AND METHODS: We compared factors associated with 5 years graft survival from RT from UDCD performed since July 2005 to December 2013 with RT from SCD in the same period in our hospital. We exclude non-primary function of the analysis of survival.
RESULTS: We performed 237 RT from UDCD and 237 from SCD. We excluded 16 vs 7 non-primary functions (p=0.07) from UDCD and SCD groups. We included 221 RT in UDCD and 230 in SCD group. 22 kidneys were lost in UDCD and 20 in SCD group: 8 vs 5 recipient's deaths (p=ns), 3 vs 5 acute rejections (p=ns), 3 vs 6 chronic rejections (p=ns), 8 vs 4 other causes, respectively. 5 years graft survival in UDCD was 89% vs 90% in SCD (p=0.5). Table shows univariable analysis.
| VARIABLE | UDCD | BD | ||||
| HR | IC | P | HR | IC | P | |
| Recipient > 50 years | 2.6 | 1.04-6.4 | 0.04 | – | – | 0.39 |
| Diabetes mellitus | 2.4 | 0.98-5.7 | 0.05 | 2.4 | 0.87-6.9 | 0.09 |
| Donor > 50 years | 3.4 | 1.40-7.9 | 0.006 | – | – | 0.5 |
| Donor’s final creatinine > 1.3 mg/dL | 2.1 | 0.85-5.2 | 0.1 | – | – | – |
| DGF | – | – | 0.8 | 5.7 | 1.60-19 | 0.006 |
| Decrease serum creatinine > 14 days | – | – | 0.5 | 3.8 | 1.40-10 | 0.008 |
| Biopsy Proven Acute rejection 1 year | 2.7 | 0.99-7.5 | 0.05 | 2.9 | 1.10-7.5 | 0.02 |
| CCr < 45 ml/min 1 year | 4.6 | 1.50-14 | 0.008 | 3.7 | 1.08-13 | 0.03 |
| Proteinuria > 1 g/day 1 year | 20 | 6.00-67 | <0.001 | – | – | 0.6 |
Multivariable data analysis shown that proteinuria >1 g/day (HR 13; 95% CI, 3.6 to 48; p=<0.001) in UDCD group and DGF (HR 9; 95% CI, 1.1 to 73; p=0.03) in SCD group are the main factors associated with graft lost after 5 years.
CONCLUSSION: Contrary to what happened in the RT from SCD group, DGF doesn't influence negatively the long-term graft survival despite increased ischemic stress and more prolonged DGF than RT from SCD. Brain death has inherent factors like catecholamine storm that could be involved in DGF and therefore, on long-term renal survival from SCD.
CITATION INFORMATION: Molina M, Cabrera J, Gonzalez E, Gutierrez E, Morales E, Hernandez E, Praga M, Andres A. Delayed Graft Function (DGF) Doesn't Affect Adversely the Long-Term Survival of Renal Transplantations (RT) from Uncontrolled Donation After Cardiac Death (UDCD) as Compared with RT from Standard Criteria Donor (SCD). Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Molina M, Cabrera J, Gonzalez E, Gutierrez E, Morales E, Hernandez E, Praga M, Andres A. Delayed Graft Function (DGF) Doesn't Affect Adversely the Long-Term Survival of Renal Transplantations (RT) from Uncontrolled Donation After Cardiac Death (UDCD) as Compared with RT from Standard Criteria Donor (SCD). [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/delayed-graft-function-dgf-doesnt-affect-adversely-the-long-term-survival-of-renal-transplantations-rt-from-uncontrolled-donation-after-cardiac-death-udcd-as-compared-with-rt-from-standard/. Accessed November 24, 2020.« Back to 2016 American Transplant Congress