Strategies to decrease organ discard are needed. We determined the adj odds of discard of DCD vs NBD kidneys in kidney donor profile index (KDPI) quartiles using multivariate logistic regression and 2000-15 SRTR data.

Results: DCD kidneys were more frequently discarded overall and in sub-groups defined by warm ischemic time (WIT) (i.e. time between the onset of the Agonal phase (when the donor's systolic blood pressure is <80mmHg or O2 saturation is <80%) and time when core cooling is initiated). There was no change in DCD discard during the study period (p>0.05).

Fig 1 shows the OR for discard of DCD kidneys with varying WIT vs NBD kidneys after adjustment for donor age, race, diabetes, hypertension, cause of death, HCV, pre-terminal creatinine, BMI, pulsatile perfusion, use of donor biopsy, shared vs local allocation, proportion of DCDs recovered in the DSA, and year of donation. Graft survival was comparable with DCD and NBD kidneys utilized for transplantation in all KDPI quartiles. Conclusion: DCD kidneys have a higher odds of discard vs NBD despite comparable outcomes and increased experience with transplantation from DCDs in recent years. These findings indicate the need for dedicated strategies to decrease DCD discard.

CITATION INFORMATION: Gill J, Rose C, Lesage J, Joffres Y, Gill J, O'Connor K. Donation After Circulatory Death (DCD) Kidneys Are More Likely to Be Discarded than Kidneys from Neurologically Brain Dead Donors (NBD). Am J Transplant. 2017;17 (suppl 3).

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