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Incidence of Delayed Graft Function in Kidneys Recovered After Normothermic Regional Perfusion

L. James1, M. D'Angelo1, J. Carillo1, J. C. Berger1, D. E. Smith1, N. Moazami1, B. Lonze2

1NYU Langone Health, New York, NY, 2NYU Langone Transplant Institute, New York, NY

Meeting: 2022 American Transplant Congress

Abstract number: 789

Keywords: Donation, Graft function, Kidney

Topic: Clinical Science » Kidney » 35 - Kidney: Cardiovascular and Metabolic Complications

Session Information

Session Name: Kidney: Cardiovascular and Metabolic Complications

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

 Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: The use of normothermic reperfusion (NRP) following donation after circulatory death (DCD) is an emerging strategy for organ procurement. NRP technique reestablishes circulatory blood flow via cardiopulmonary bypass after the period of circulatory arrest. In this study we evaluated the incidence of delayed graft function (DGF) in recipients of DCD renal allografts recovered using NRP technique.

*Methods: The United Network for Organ Sharing (UNOS) database was used to identify recipients of NRP kidneys procured at our institution. For each NRP kidney, propensity score matching was used to identify 5 controls from the pool of standard DCD kidney recipients. Parameters for matching included: donor and recipient age, donor terminal creatinine (Cr), warm ischemic time (WIT), cold ischemic time (CIT), kidney donor profile index (KDPI), and recipient dialysis status prior to transplant. DGF was defined as requiring dialysis within 7 days of transplantation.

*Results: Nine DCD NRP and 45 standard DCD kidney transplants were evaluated. The NRP and standard DCD groups were well-matched across covariates expected to confound analysis of DGF (Table 1). Only 1/9 (1.1%) of the NRP recipients 2/45 (4.4%) of the standard DCD kidney recipients received a pre-emptive transplant. The incidence of DGF was identical among recipients of NRP DCD kidneys (4/9) and standard DCD kidneys (20/45; 44.4%, p=1.0).

Standard DCD Kidneys (n=45) NRP DCD Kidneys (n=9)
Donor characteristics
Age, years 32.9±10.5 36.6±8.8
Male gender, n (%) 31 (68.9) 7 (77.8)
BMI 28.2±6.2 31.2±5.5
Ethnicity, n (%)
White 41 (91.1) 9 (100.0)
Hispanic 2 (4.4) 0
Asian 1 (2.2) 0
Hawaiian/Pacific Islander 1 (2.2) 0
Anoxia as cause of death, n (%) 28 (62.2) 8 (88.9)
KDPI (%) 33.7±0.2 37.2±0.2
Terminal Cr 2.03±2.06 2.18±2.14
CIT, hours 23.4±12.2 21.5±9.7
WIT, minutes 28.4±13.7 30.0±4.7
Recipient characteristics
Age, years 53.8±13.7 49.6 ± 10.8
Male gender, n (%) 21 (46.7) 5 (55.6)
BMI 29.6±6.5 24.3 ± 2.9
Ethnicity, n (%)
White 19 (42.2) 3 (33.3)
Black 13 (28.9) 1 (11.1)
Hispanic 6 (13.3) 4 (44.4)
Asian 5 (11.1) 1 (11.1)
Dialysis, n (%) 43 (95.6) 8 (88.9)
Time on waitlist, days 1,740±848 1,418±1,454
Calculated panel reactive antibodies 23.4±37.3 32.4±43.5

*Conclusions: In our early experience with NRP in DCD kidney donation, rates of DGF are comparable to rates of DGF in standard DCD donation.

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To cite this abstract in AMA style:

James L, D'Angelo M, Carillo J, Berger JC, Smith DE, Moazami N, Lonze B. Incidence of Delayed Graft Function in Kidneys Recovered After Normothermic Regional Perfusion [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/incidence-of-delayed-graft-function-in-kidneys-recovered-after-normothermic-regional-perfusion/. Accessed May 16, 2025.

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