Outcomes of Kidneys from Donors After Cardiac Death: Implications for Allocation and Preservation

Locke, Jayme E.; Segev, Dorry L.; Warren, Daniel; Dominici, Francesca; Simpkins, Christopher E.; Montgomery, Robert A.

doi:10.1111/j.1600-6143.2007.01852.x

Cited by 223 publications

(223 citation statements)

References 31 publications

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“…There was no relationship between donor hypertension and graft survival. This contrasts with earlier work that found donor hypertension may have an effect on graft survival [24][25][26]. The number of patients in our study with hypertension may have been insufficient to demonstrate this effect and diagnosis or reporting of donor hypertension may have been incomplete; this result should therefore be explored in further research with a larger group of patients.…”

Section: Discussioncontrasting

confidence: 92%

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Sevinc¹,

Stamp

Carter

et al. 2016

Transplantation Proceedings

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Section: Discussioncontrasting

confidence: 92%

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Sevinc¹,

Stamp

Carter

et al. 2016

Transplantation Proceedings

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“…Our multivariable analysis revealed that the Remuzzi score was the only independent predictor for kidney graft survival, emphasizing that chronic renal injury acquired in the donor is a major determinant of kidney transplant outcome, but further suggesting that factors such as donor age and ECD status, which are commonly considered to impact upon transplant outcome (3,(22)(23)(24) and which were included in our analysis, may instead be surrogate markers for the presence of baseline chronic degenerative changes.…”

Section: Discussionmentioning

confidence: 96%

Baseline Donor Chronic Renal Injury Confers the Same Transplant Survival Disadvantage for DCD and DBD Kidneys

Kosmoliaptsis

Salji

Bardsley

et al. 2015

American Journal of Transplantation

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Histological assessment of baseline chronic kidney injury may discriminate kidneys that are suitable for transplantation, but has not been validated for appraisal of donation after circulatory death (DCD) kidneys. 'Time-zero' biopsies for 371 consecutive, solitary, deceased-donor kidneys transplanted at our center between 2006 and 2010 (65.5% DCD, 34.5% donation after brain death [DBD]) were reviewed and baseline chronic degenerative injury scored using Remuzzi's classification. High scores correlated with donor age and extended criteria donors (42% of donors), but the spectrum of scores was similar for DCD and DBD kidneys. Transplant outcomes for kidneys scoring from 0 to 4 were comparable (1 and 3 year graft survival 95% and 92%), but were much poorer for kidneys scoring !5, with 1 year graft survival only 73%, and 12.5% suffering primary nonfunction. Critically, high Remuzzi scores conferred the same survival disadvantage for DCD and DBD kidneys. On multi-variable regression analysis, time-zero biopsy score was the only independent predictor for graft survival, whereas one-year graft estimated glomerular filtration rate (eGFR) correlated with donor age and biopsy score. In conclusion, the relationship between severity of chronic kidney injury and transplant outcome is similar for DCD and DBD kidneys. Kidneys with Remuzzi scores of 4 can be implanted singly with acceptable results.

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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.

show abstract

Outcomes of Kidneys from Donors After Cardiac Death: Implications for Allocation and Preservation

Cited by 223 publications

References 31 publications

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Baseline Donor Chronic Renal Injury Confers the Same Transplant Survival Disadvantage for DCD and DBD Kidneys

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

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