Kidney transplant from uncontrolled donation after circulatory death donors maintained by nECMO has long‐term outcomes comparable to standard criteria donation after brain death. Issue 2 (16th August 2018)

• Record Type: Journal Article
• Authors: Molina, María; Guerrero‐Ramos, Félix; Fernández‐Ruiz, Mario; González, Esther; Cabrera, Jimena; Morales, Enrique; Gutierrez, Eduardo; Hernández, Eduardo; Polanco, Natalia; Hernández, Ana; Praga, Manuel; Rodriguez‐Antolín, Alfredo; Pamplona, Manuel; de la Rosa, Federico; Cavero, Teresa; Chico, Mario; Villar, Alicia; Justo, Iago; Andrés, Amado
• Is Part Of: American journal of transplantation. Volume 19:Issue 2(2019)
• Page Start: 434
• Page End: 447
• Publication Date: 2018-08-16
• Subjects: clinical research / practice -- donors and donation: donation after brain death (DBD) -- donors and donation: donation after circulatory death (DCD) -- extracorporeal membrane oxygenation (ECMO) -- graft survival -- kidney disease -- kidney transplantation / nephrology; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.14991
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Uncontrolled donation after circulatory death (uDCD) increases organ availability for kidney transplant (KT) with short‐term outcomes similar to those obtained from donation after brain death (DBD) donors. However, heterogeneous results in the long term have been reported. We compared 10‐year outcomes between 237 KT recipients from uDCD donors maintained by normothermic extracorporeal membrane oxygenation (nECMO) and 237 patients undergoing KT from standard criteria DBD donors during the same period at our institution. We further analyzed risk factors for death‐censored graft survival in the uDCD group. Delayed graft function (DGF) was more common in the uDCD group (73.4% vs 46.4%; P < .01), although glomerular filtration rates at the end of follow‐up were similar in the 2 groups. uDCD and DBD groups had similar rates for 10‐year death‐censored graft (82.1% vs 80.4%; P = .623) and recipient survival (86.2% vs 87.6%; P = .454). Donor age >50 years was associated with graft loss in the uDCD group (hazard ratio: 1.91; P = .058), whereas the occurrence of DGF showed no significant effect. uDCD KT under nECMO support resulted in similar graft function and long‐term outcomes compared with KT from standard criteria DBD donors. Increased donor age could negatively affect graft survival after uDCD donation. Abstract : Kidney transplant recipients from uncontrolled donation after circulatory death donors preserved with normothermic extracorporeal membrane oxygenation have long‐term outcomes comparable to recipients from standard criteria donation after brain death donors.