J Korean Soc Transplant.  2015 Dec;29(4):216-226. 10.4285/jkstn.2015.29.4.216.

The Long-term Outcomes of Kidney Transplantation from Donation after Circulatory Death during Brain Death Donor Evaluation in a Single Center in Korea

• Hur N
• Park H
• Lee K
• Choi G
• Kim JM
• Park JB
• Kwon CH
• Kim SJ
• Joh JW
• Lee SK

• KMID: 2202607
• DOI: http://doi.org/10.4285/jkstn.2015.29.4.216

Abstract

BACKGROUND
While the number of deceased donor donations has increased in Korea, the organ shortage remains a major limitation for kidney transplantation. Donation after circulatory death (DCD) can be an option to expand the donor pool. In this study we evaluated the short and long term survival of grafts and patients and assessed the risk factors for graft failure.
METHODS
In a single center, from August 1997 to December 2013, 28 cases of recipients who received kidney transplantation from DCD were enrolled. Information about donor and recipient factors, graft conditions, and transplant outcomes was collected through review of medical records. We calculated overall graft and patient survival rates and the risk factors for graft failure according to donor criteria and whether or not delayed graft function (DGF) occurred.
RESULTS
There was no primary non-function, but DGF developed in 67.9% (19/28). Graft losses occurred in five patients during a median follow-up period of 68.2 months (4~204). There was no significant difference in graft survival rates depending on the donor criteria and the occurrence of DGF. In addition, there were no noteworthy risk factors for graft failure among donor age, donor creatinine, extended criteria donor, recipient age, warm ischemic time, cold ischemic time, and DGF.
CONCLUSIONS
In this study, despite the high incidence of DGF, the long-term graft and patient survival in kidney transplantation from DCD were acceptable. Therefore, DCD can be an alternative to expand the donor pool and to shorten the waiting time.

Keyword

Kidney transplantation; Donation after circulatory death; Graft survival

MeSH Terms

Brain Death*
Brain*
Cold Ischemia
Creatinine
Delayed Graft Function
Follow-Up Studies
Graft Survival
Humans
Incidence
Kidney Transplantation*
Kidney*
Korea*
Medical Records
Risk Factors
Survival Rate
Tissue Donors*
Transplants
Warm Ischemia
Creatinine

Figure

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  Fig. 1. Overall survival. (A) Donation after circulatory death (DCD): overall graft survival. (B) DCD: overall patient survival.

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  Fig. 2. Survival according to donor criteria (standard criteria donor [SCD] vs. extended criteria donor [ECD]). (A) Donation after circulatory death (DCD): graft survival according to donor criteria (SCD vs. ECD). (B) DCD: patient survival according to donor criteria (SCD vs. ECD).

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  Fig. 3. Survival according to delayed graft function (DGF) occurrence. (A) Graft survival according to DGF occurrence. (B) Patient survival according to DGF occurrence.

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  Fig. 4. Overall survival (donation after circulatory death [DCD] vs. donation after brain death [DBD]). (A) Overall graft survival. (B) Overall patient survival. (C) Graft survival according to donor criteria (DCD-standard criteria donor [SCD] vs. DCD-extended criteria donor [ECD] vs. DBD-SCD vs. DBD-ECD). (D) Patient survival according to donor criteria (DCD-SCD vs. DCD-ECD vs. DBD-SCD vs. DBD-ECD).

Reference

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