Kidney transplant outcomes in elderly recipients with controlled donation after circulatory death or donation after brain death donors: a registry cohort study. (11th November 2021)

• Record Type: Journal Article
• Authors: Pérez‐Sáez, María José; Juega, Javier; Zapatero, Ana; Comas, Jordi; Tort, Jaume; Lauzurica, Ricardo; Pascual, Julio
• Is Part Of: Transplant international. Volume 34:Number 12(2021)
• Page Start: 2507
• Page End: 2514
• Publication Date: 2021-11-11
• Subjects: controlled circulatory death -- donors -- elderly -- kidney transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.14141
• Languages: English
• ISSNs: 0934-0874

Abstract

Summary: The number of kidney transplant (KT) procedures with controlled donation after circulatory death (cDCD) donors has exponentially increased in Spain in recent years, with a parallel increase in donor and recipient acceptance criteria. The outcomes of cDCD‐KT have been reported to be comparable to those of KT with donation after brain death (DBD) donors. However, studies in elderly recipients have yielded contradictory results. We performed a registry analysis of 852 KT recipients aged ≥65 years (575 in the DBD‐KT group, 277 in the cDCD‐KT group) in Catalonia, Spain. Clinical outcomes and survival were compared between DBD‐KT and cDCD‐KT recipients. The donor and recipient ages were similar between the two groups (71.5 ± 8.7 years for donors, 70.8 ± 4.1 years for recipients). Delayed graft function (DGF) was more frequent among cDCD‐KT recipients, without a difference in the rate of primary nonfunction. The 3‐year patient and death‐censored graft survival rates were similar between DBD‐KT and cDCD‐KT recipients (78.8% vs. 76.4% and 90.3% vs. 86.6%, respectively). In multivariable analysis, previous cardiovascular disease and DGF were independent risk factors for patient death. The type of donation (cDCD vs. DBD) was not an independent risk factor for patient survival or graft loss. cDCD‐KT and DBD‐KT provide comparable patient and graft survival in elderly recipients. Abstract : A total of 852 KT recipients aged ≥65 years (575 from DBD and 277 from cDCD) were included in the analysis. The 3‐year patient and death‐censored graft survival rates were similar between DBD and cDCD‐KT (78.8% vs. 76.4% and 90.3% vs. 86.6%, respectively). Cardiovascular disease and DGF were independent risk factors for patient death. The type of donation (cDCD vs. DBD) did not impact in patient survival/graft loss.