Kidney Transplantation Outcomes From Donors After Controlled Circulatory Death: A Comparison With Expanded Criteria Brain Death Donors |
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| Affiliation: | 1. Department of General Surgery, Liver Transplantation Unit, University Hospital Complex A Coruña, A Coruña, Spain;2. Department of Thoracic Surgery, Lung Transplantation Unit, University Hospital Complex A Coruña, A Coruña, Spain;1. Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, Córdoba, Spain;2. Group for the Study of Thoracic Neoplasms and Lung Transplantation, IMIBIC (Instituto Maimónides de Investigación Biomédica de Córdoba), University of Córdoba. Córdoba, Spain;3. Department of Pathology, University Hospital Reina Sofia, Córdoba, Spain;1. Immunology Department, Marqués de Valdecilla University Hospital, 39008, Santander, Spain;2. Autoimmunity and Transplantation Research Group, Research Institute “Marqués de Valdecilla” (IDIVAL), Santander, Spain;3. Nephrology Department, Marqués de Valdecilla University Hospital, Santander, Spain;1. Kidney Transplant Unit, Department of Nephrology, Hospital Universitario La Fe, Valencia, Spain;2. Pharmacy Service, Hospital Universitario La Fe, Valencia Spain;3. IIS La Fe - Medical Research Institute Hospital La Fe, Hospital Universitario La Fe, Valencia, Spain;1. Department of Clinical Biochemistry, Virgen del Rocío University Hospital, Seville, Spain;2. Hepatobiliary and Liver Transplant Unit, General and Digestive Surgery Department, Virgen del Rocío University Hospital, Seville, Spain |
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| Abstract: | BackgroundThe persistent shortage of optimal kidney donors and the progressive increase in patients on the waiting list have led to an expansion of the acceptance criteria, such as donors after controlled cardiac death (cDCD) and donors after brain death with expanded criteria (DBD-EC). Some concerns and doubts about survival outcomes achieved with these allografts are still present. Our aim was to compare transplant outcomes from cDCD vs DBD-EC.MethodsA retrospective single-center observational study including all kidney transplant (KT) donors from all cDCD and DBD-EC (>60 years) from January 2015 to January 2022 was performed. We analyzed clinical characteristics, early clinical outcomes, and patient and graft survival rates.Results129 cDCD and 166 DBD-EC KT recipients were included. The median follow-up was 30,2 months. DBD-EC were older and had more comorbidities than cDCD. KTs from cDCD and DBD-EC showed similar rates of delayed graft function and primary nonfunction. Patient survival at 1 year was similar (85% DBD-EC vs 90% cDCD, P = .32). Death-censored graft survival at 1 year was similar among young cDCD (18-59 years) and elderly DBD (60-69 years; 97% vs 92.3%, P = .2). Recipient age and expanded criteria in KT from cDCD were related to worse early graft outcomes. The outcomes achieved with KT from cDCD were similar to those observed in older and more comorbid DBD donors. This assumption is worth consideration when choosing the most suitable donor for each recipient. |
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