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.
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 December 2, 2024.« Back to 2022 American Transplant Congress