The national protocol for the uDCD program restricts the no flow period to <30 min and the total warm ischemia time (WIT) to <150 min. In situ kidney perfusion is realized by a double-balloon catheter or by a regional normothermic circulation (RNC). Kidneys are placed on a perfusion machine. Eligible recipients must be less than 60 years old, listed for a 1st transplantation and non-immunized.
The aim of this study was to compare 1-year graft function and survival rates according to three types of donors: uDCD donors, donors after brain death (DBD) with non-extended criteria (DBD-NECD) and those with extended criteria (DBD-ECD), only among eligible patients for the uNHBD program.
Between 01/01/2007 and 31/12/2009, 160 eligible recipients were transplanted with uDCD, 894 with DBD-NECD and 255 with DBD-ECD (mean follow up of 328 days with an end-point at March 1st 2011).
uDCD transplanted patients had a shorter waiting time before transplantation, were more often of the B blood group, received more graft from male donors and right kidney, had shorter CIT and poor HLA matching.
Primary non function incidence was comparable between the 3 groups. Delayed graft function was significantly more frequent in case of uDCD [76% vs. 36% (NECD) and 45% (ECD)]. We observed a difference in 1-year renal clearance only between uDCD patients and NECD patients (47.8 vs. 56.1 ml/min). 1-year graft survival was significantly different according to donor type (p=0.012) with 90.7% for uDCD patients, 95.3% for NECD patients and 91.1% for ECD patients. After adjustment, a significant increased risk of failure remains in uDCD recipients compared to NECD [RR of NECD vs. NHBD = 0.507].
uDCD kidneys represent a valuable additional source of organs for transplantation but 1-year survival and renal function appear more comparable to renal transplantation with ECD than those with optimal donors.
To cite this abstract in AMA style:Antoine C, Savoye E, Viglietti D, Cheisson G, Barrou B, Morelon E, Thuong M. Uncontrolled Donors after Circulatory Death (uDCD) for Kidney Transplantation: Marginal or Optimal Donor? [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/uncontrolled-donors-after-circulatory-death-udcd-for-kidney-transplantation-marginal-or-optimal-donor/. Accessed January 25, 2021.
« Back to 2013 American Transplant Congress