Kidney transplantation from donation after cardiac death donors: lack of impact of delayed graft function on post‐transplant outcomes

Singh, Rajinder; Farney, Alan C.; Rogers, Jeffrey; Zuckerman, Jack M.; Reeves‐Daniel, Amber; Hartmann, Erika; Iskandar, Samy S.; Adams, Patricia L.; Stratta, Robert J.

doi:10.1111/j.1399-0012.2010.01241.x

Cited by 129 publications

(116 citation statements)

References 35 publications

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“…>50 years) and CIT > 12 h and does not necessarily compromise longer term renal function or patient/graft survival (relative to patients receiving donation after brain death donor kidneys) 32, 33, 34. Regardless, DCD kidneys are marginalized, with stigma surrounding their use (i.e.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety Outcomes of Extended Criteria Donor Kidneys by Subtype: Subgroup Analysis of BENEFIT-EXT at 7 Years After Transplant

Florman

Becker

Bresnahan

et al. 2017

American Journal of Transplantation

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The phase III Belatacept Evaluation of Nephroprotection and Efficacy as First‐Line Immunosuppression Trial–Extended Criteria Donors Trial (BENEFIT‐EXT) study compared more or less intensive belatacept‐based immunosuppression with cyclosporine (CsA)–based immunosuppression in recipients of extended criteria donor kidneys. In this post hoc analysis, patient outcomes were assessed according to donor kidney subtype. In total, 68.9% of patients received an expanded criteria donor kidney (United Network for Organ Sharing definition), 10.1% received a donation after cardiac death kidney, and 21.0% received a kidney with an anticipated cold ischemic time ≥24 h. Over 7 years, time to death or graft loss was similar between belatacept‐ and CsA‐based immunosuppression, regardless of donor kidney subtype. In all three donor kidney cohorts, estimated mean GFR increased over months 1–84 for belatacept‐based treatment but declined for CsA‐based treatment. The estimated differences in GFR significantly favored each belatacept‐based regimen versus the CsA‐based regimen in the three subgroups (p < 0.0001 for overall treatment effect). No differences in the safety profile of belatacept were observed by donor kidney subtype.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety Outcomes of Extended Criteria Donor Kidneys by Subtype: Subgroup Analysis of BENEFIT-EXT at 7 Years After Transplant

Florman

Becker

Bresnahan

et al. 2017

American Journal of Transplantation

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“…It appears that as in SCDs, long term graft survival is not necessarily affected by DGF and CI not necessarily an independent predictor of graft survival. Recent evidence from clinical DCD and DBD programmes have reported similar rates of graft survival after 5 and 10 years [45, [54][55][56][57]. In a series of 112 uncontrolled DCD kidneys, DGF rates were 84% compared to 22% in DBD donors [54].…”

Section: Donor Specific Effectsmentioning

confidence: 92%

Cold Ischaemic Injury in Kidney Transplantation

Hosgood¹,

Hunter²,

Nicholson³

2012

Current Concepts in Kidney Transplantation

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“…Donation after cardiac death donor kidney transplants with DGF had lower 2-year mean serum creatinine level than DBD kidney transplants experiencing DGF. 18 There may be different pathogenesis of DGF in kidney transplants from DCD or DBD donor, which results in the different effect of DGF on the graft survival of kidney transplants from DCD or DBD.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Yuan

Han

Wang

et al. 2014

Exp Clin Transplant

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where we hosted one of the largest donation after cardiac death organ transplant programs in the country. We report our initial single-center experiences of kidney transplant from donation after cardiac deaths. Materials and Methods: From January 2011 to July 2013 at our center, 101 kidney transplants from donation after cardiac death donors were performed. The results of kidney transplants from donation after cardiac death donors were compared with those of 50 kidney transplants from donation after brain death performed during the same time. Results: Delayed graft function occurred more frequently in donation after cardiac death than donation after brain death kidneys (16.8% vs 4.0%; P = .035). There was no difference in the incidence of acute rejection between donation after cardiac death and donation after brain death kidneys (10.9% vs 6.0%). Actual 1-year graft survival rate was similar (donation after cardiac death 94.4% vs donation after brain death 96.2%). Estimated glomerular filtration rate at 12 months was similar between donation after cardiac death and donation after brain death kidneys (73.8 ± 20.0 vs 77.8 ± 22.7 mL/min/1.73m 2 ). Conclusions: Kidney transplants from donation after cardiac death donors have comparable short-term outcomes to kidney transplants from donation after brain death donors. Donation after cardiac death can play a crucial role in overcoming the organ shortage in China.

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Kidney transplantation from donation after cardiac death donors: lack of impact of delayed graft function on post‐transplant outcomes

Abstract: Despite higher rates of DGF and acute rejection in DCD donor kidney transplants, subsequent outcomes in DCD donor kidney transplants with DGF are better than in DBD donor kidney transplants experiencing DGF, and similar to outcomes in DCD donor kidney transplants without DGF.

Cited by 129 publications

References 35 publications

Efficacy and Safety Outcomes of Extended Criteria Donor Kidneys by Subtype: Subgroup Analysis of BENEFIT-EXT at 7 Years After Transplant

Efficacy and Safety Outcomes of Extended Criteria Donor Kidneys by Subtype: Subgroup Analysis of BENEFIT-EXT at 7 Years After Transplant

Cold Ischaemic Injury in Kidney Transplantation

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