One Year Outcomes and Quality of Life Measurements in 127 Extended Criteria Donor Recipients- A Single Centre Comparative Study

Y. Tabbakh,¹ S. Turner,¹ H. Maple,¹ C. Callaghan,¹ J. Olsburgh,¹ F. Calder,¹ M. Drage,¹ N. Karydis,¹ I. Loukopoulos,¹ G. Koffman,¹ R. Hilton,¹ J. Pattison,¹ C. Farmer,³ S. Shah,² E. Spigler,¹ N. Mamode,¹ N. Kessaris.¹

¹Guys Hospital, London, United Kingdom
²Kings Hospital, London, United Kingdom
³Kent & Canterbury Hospital, Kent, United Kingdom.

Meeting: 2015 American Transplant Congress

Abstract number: C56

Keywords: Donors, marginal

Session Information

Session Name: Poster Session C: ECD/DCD/high KDPI

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Introduction: Expanded criteria donors (ECDs) are those aged over 60 or 50-59 with 2 of: hypertension, death from cerebrovascular cause or terminal serum creatinine over 1.5mg/dL. They can be sub-divided into a junior group (less than 70yrs, jECD) and a senior group (over 70yrs, sECD). Outcome data and measurement of quality of life (QOL) from such donors is limited.

Methods: We analysed 1 year results for deceased donor (DD) kidney transplants performed between 2012 & 2013. Patients were asked to complete a QOL questionnaire including Life satisfaction (Satisfaction with Life Scale), Mood (Perceived Health Questionnaire-2), Distress (General Health Questionnaire) & Health-related quality of life (SF12).

Results: Of 253 DD transplants, 126 (49.8%) were from standard criteria donors (SCD) and 127 (51.2%) from ECD. Of the ECDs, 86 were jECD and 40 were sECD. There were 5 deaths with a functioning graft, 3 SCD (at day 13, 17 & 57), and 2 ECDs (at day 104 & 132). All-cause graft loss was 13 (5%) [7 (2.8%) SCD, 8 (3.2%) ECD, 5 (5.8%) jECD & 3 (7.5%) sECD]. The Karpinsky-score was significantly different (p=0.001) between 85 SCD biopsies (mean 2.67, SD 1.5) & 89 ECD biopsies (mean 4.19, SD 1.4). Primary non-function rates were 2.4% for SCD, 5.5% for ECD, 3.5% for jECD and 10% for sECD. Delayed graft function rate was 41% in SCD, 51% in ECD, 51% in jECD and 53% in sECD. Mean MDRD eGFR was significantly higher in the SCD group than the ECD group at 3 months (47 vs 34; p<0.001) & 12 months (49 vs 36; p<0.001). There was no difference in GFR between jECD & sECD recipients (p= 0.289) and number of biopsies or in median LOS (17.8 days SCD vs 20.2 days ECD; p=0.498) in the first 12 months. Of the 127 patients who completed the QOL questionnaire, there was no statistically significant difference in any of the quality of life measures between the different categories (DBD vs. DCD; SCD vs. ECD; Single vs. double) p=0.005

Conclusions: Although there is no significant difference in patient or graft survival at 12 months (p=0.069 & p=0.087) or QOL, eGFR is significantly reduced in ECDs. This should form part of consenting such recipients prior to transplantation.

To cite this abstract in AMA style:

Tabbakh Y, Turner S, Maple H, Callaghan C, Olsburgh J, Calder F, Drage M, Karydis N, Loukopoulos I, Koffman G, Hilton R, Pattison J, Farmer C, Shah S, Spigler E, Mamode N, Kessaris N. One Year Outcomes and Quality of Life Measurements in 127 Extended Criteria Donor Recipients- A Single Centre Comparative Study [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/one-year-outcomes-and-quality-of-life-measurements-in-127-extended-criteria-donor-recipients-a-single-centre-comparative-study/. Accessed November 21, 2024.

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