Date: Monday, May 4, 2015
Session Name: Concurrent Session: Kidney: KDPI and Non Ideal Kidneys
Session Time: 4:00pm-5:30pm
Presentation Time: 5:00pm-5:12pm
Location: Room 118-AB
Introduction: Kidneys from donation after circulatory-death donors currently make up over 40% of deceased donor kidney transplants in the UK. In addition, 34% of deceased donor kidneys transplanted in the UK are from kidneys from older donors (>60 years). We used the largest international cohort of recipients of such kidneys to assess long-term transplant outcome.
Methods: A comprehensive analysis of adult recipients of DCD and DBD (donation after brain death) donor kidneys performed in the UK between 2001 and 2012 was performed, using data from the UK transplant registry. Cox proportional hazards and multiple linear regression were used to compare graft survival and function.
Results: 3626 DCD and 9683 DBD donor kidneys were included in the analysis with a median follow-up of 7.5 years (IQR 4.5-10.7). 1013 (27%) of DCD kidneys and 2110 (22%) of DBD kidneys were from donors aged over 60 years. Unadjusted 5 and 10 year death-censored graft survival was 85.9% and 74.9% for recipients of DCD kidneys and 84.5% and 74.3% for recipients of DBD kidneys with an adjusted hazard ratio (DCD compared to DBD) for 10 year graft survival of 0.95 (95% CI 0.8 to 1.1, p=0.42). There was no interaction between donor age over 60 years and donor type (p=0.40). There was no significant difference in the incidence of primary non-function 3.1% vs 2.6% (p=0.06) for DCD and DBD donors, respectively. Graft function (estimated glomerular filtration rate) was 49.6 ml/min/1.73m2 and 48.1 ml/min/1.73m2 for DCD and DBD recipients 5 years post transplant respectively, and risk-adjusted regression analysis demonstrated no difference between the groups (regression estimate 0.02 (95% CI -1.1 to 1.2, p=0.97).
Discussion: Recipients of kidneys from DCD donors have equivalent graft survival up to 10 years post transplant and equivalent graft function 5 years after transplantation to recipients of DBD kidneys, irrespective of donor age. DCD donor kidneys have provided an excellent source of kidneys for transplantation.
To cite this abstract in AMA style:Summers D, Johnson R, Collett D, Watson C, Neuberger J, Pettigrew G, Bradley J. Kidney Transplantation Using Kidneys from Donation After Circulatory Death Donors: Results from the UK Experience [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-transplantation-using-kidneys-from-donation-after-circulatory-death-donors-results-from-the-uk-experience/. Accessed February 24, 2021.
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