Outcomes of kidneys from donors after cardiac death: Implications for allocation and preservation

Academic Article

Abstract

  • Although donation after cardiac death (DCD) kidneys have a high incidence of delayed graft function (DGF) and have been considered marginal, no tool for stratifying risk of graft loss nor a specific policy governing their allocation exist. We compared outcomes of 2562 DCD, 62 800 standard criteria donor (SCD) and 12 812 expanded criteria donor (ECD) transplants reported between 1993 and 2005, and evaluated factors associated with risk of graft loss and DGF in DCD kidneys. Donor age was the only criterion used in the definition of ECD kidneys that independently predicted graft loss among DCD kidneys. Kidneys from DCD donors <50 had similar long-term graft survival to those from SCD (RR 1.1, p = NS). While DGF was higher among DCD compared to SCD and ECD, limiting cold ischemia (CIT) to ≤12 h decreased the rate of DGF 15% among DCD <50 kidneys. These findings suggest that DCD <50 kidneys function like SCD kidneys and should not be viewed as marginal or ECD, and further, limiting CIT <12 h markedly reduces DGF. © 2007 The Authors.
  • Authors

    Digital Object Identifier (doi)

    Pubmed Id

  • 8170352
  • Author List

  • Locke JE; Segev DL; Warren DS; Dominici F; Simpkins CE; Montgomery RA
  • Start Page

  • 1797
  • End Page

  • 1807
  • Volume

  • 7
  • Issue

  • 7