Survival outcomes from DCD renal transplant are comparable to DBD transplants from kidneys procured from donors over 50 years of age: UNOS/OPTN analysis
Sources of Funding: none
Introduction
There is hesitancy when utilizing DCD grafts of older age. We assess the long-term graft/ patient survival outcomes in donation after cardiac death ( DCD) and donation after brain death (DBD) transplants from kidneys procured from donors > 50 years of age.
Methods
Utilizing the UNOS/OPTN database, we analyzed 14288 deceased donor kidney transplants (1833 DCD and 13533 DBD) from donors > 50 years between 2005-2013. Analysis of graft and patient survival was with multivariate regression analysis and Cox models with single imputation by dummy variable method to manage missing data.
Results
Donor and recipient demographics between DCD and DBD recipients were similar including donor age, BMI, history of diabetes, and smoking. However, KDRI Rao was 1.5 (1.06-3.31) in DCD and 1.6 in DBD (1.6 (0.96-4.1), which was significant (p<0.001). Death censored graft survival in patients receiving grafts from donors >50 years at 1 and 5 years was 90 and 76% in DCD group vs 92% and 77% in DBD (p = NS). Furthermore, patient survival was 90 and 70% in DCD vs. 91 and 72% in DBD ( p = NS). _x000D_ _x000D_ When analyzing patients receiving grafts >60 years of age, graft survival was similar between DCD and DBD groups, but patient survival was inferior in the DCD group (p<0.05).
Conclusions
Results of renal transplantation with grafts >50 years are similar between DCD and DBD recipients, but caution should be taken when utilizing grafts >60 years.
Funding
none
Hemant Sharma
Jingwen Chen
Alp Sener