Strict selection criteria in uncontrolled donation after circulatory death provide excellent long-term kidney graft survival

Clin Transplant. 2020 Sep;34(9):e14010. doi: 10.1111/ctr.14010. Epub 2020 Jul 15.

Abstract

Background: We aimed to report our experience in uncontrolled donation after circulatory death (uDCD) kidney transplantation applying a strict donor selection and preservation criteria.

Methods: All kidney recipients received a graft from a local uDCD. As controls, we included all renal transplants from local standard criteria donation after brain death (SDBD) donors. Normothermic regional perfusion was the preservation method in all cases.

Results: A total of 19 kidneys from uDCD donors were included and 67 controls. Delayed graft function (DGF) was higher in the uDCD group (42.1% vs 17.9%; P = .033), whereas no differences were observed in primary nonfunction (0% cases vs 3% controls; P = .605). The estimated glomerular filtration rate was identical in both groups. No differences were observed in graft survival censored for death between the uDCD and the SDBD groups at 1-year (100% vs 95%) or 5-year follow-up (92% vs 91%). uDCD kidney recipients did not have higher risk of graft loss in the multivariate analysis adjusted by recipient age, cold ischemic time, presence of DGF, and second kidney transplant (HR: 0.4; 95% CI 0.02-6; P = .509).

Conclusions: Obtaining renal grafts from uDCD is feasible in a small city and provides similar outcomes compared to standard DBD donors.

Keywords: clinical study; kidneys; primary nonfunction; uncontrolled donation after circulatory death.

MeSH terms

  • Delayed Graft Function
  • Graft Survival
  • Humans
  • Kidney
  • Kidney Transplantation*
  • Patient Selection
  • Tissue Donors
  • Tissue and Organ Procurement*