BACKGROUND: Delayed graft function (DGF) and acute rejection (AR) exert an adverse impact on graft outcomes after kidney transplantation using organs from donation after brain-stem death (DBD) donors. Here, we examine the impact of DGF and AR on graft survival in kidney transplants using organs from donation after cardiac death (DCD) donors. METHODS: We conducted a single-center retrospective study of DCD and DBD donor kidney transplants. We compared 1- and 4-year graft and patient survival rates, as well as death-censored graft survival (DCGS) rates, between the two groups using univariate analysis, and the impact of DGF and AR on graft function was compared using multivariate analysis. RESULTS: Eighty DCD and 206 DBD donor transplants were analyzed. Median follow-up was 4.5 years. The incidence of DGF was higher among DCD recipients (73% vs. 27%, P<0.001), and AR was higher among DBD recipients (23% vs. 9%, P<0.001). One-year and 4-year graft survival rates were similar (DCD 94% and 79% vs. DBD 90% and 82%). Among recipients with DGF, the 4-year DCGS rate was better for DCD recipients compared with DBD recipients (100% vs. 92%, P=0.04). Neither DGF nor AR affected the 1-year graft survival rate in DCD recipients, whereas in DBD recipients, the 1-year graft survival rate was worse in the presence of DGF (88% vs. 96%, P=0.04) and the 4-year DCGS rate was worse in the presence of AR (88% vs. 96%, P=0.04). CONCLUSION: Despite the high incidence of DGF, medium-term outcomes of DCD kidney transplants are comparable to those from DBD transplants. Short-term graft survival from DCD transplants is not adversely influenced by DGF and AR, unlike in DBD transplants.
BACKGROUND: Delayed graft function (DGF) and acute rejection (AR) exert an adverse impact on graft outcomes after kidney transplantation using organs from donation after brain-stem death (DBD) donors. Here, we examine the impact of DGF and AR on graft survival in kidney transplants using organs from donation after cardiac death (DCD) donors. METHODS: We conducted a single-center retrospective study of DCD and DBDdonor kidney transplants. We compared 1- and 4-year graft and patient survival rates, as well as death-censored graft survival (DCGS) rates, between the two groups using univariate analysis, and the impact of DGF and AR on graft function was compared using multivariate analysis. RESULTS: Eighty DCD and 206 DBDdonor transplants were analyzed. Median follow-up was 4.5 years. The incidence of DGF was higher among DCD recipients (73% vs. 27%, P<0.001), and AR was higher among DBD recipients (23% vs. 9%, P<0.001). One-year and 4-year graft survival rates were similar (DCD 94% and 79% vs. DBD 90% and 82%). Among recipients with DGF, the 4-year DCGS rate was better for DCD recipients compared with DBD recipients (100% vs. 92%, P=0.04). Neither DGF nor AR affected the 1-year graft survival rate in DCD recipients, whereas in DBD recipients, the 1-year graft survival rate was worse in the presence of DGF (88% vs. 96%, P=0.04) and the 4-year DCGS rate was worse in the presence of AR (88% vs. 96%, P=0.04). CONCLUSION: Despite the high incidence of DGF, medium-term outcomes of DCD kidney transplants are comparable to those from DBD transplants. Short-term graft survival from DCD transplants is not adversely influenced by DGF and AR, unlike in DBD transplants.
Authors: Eric S Orman; Maria E Mayorga; Stephanie B Wheeler; Rachel M Townsley; Hector H Toro-Diaz; Paul H Hayashi; A Sidney Barritt Journal: Liver Transpl Date: 2015-08 Impact factor: 5.799
Authors: Islam M Korayem; Vatche G Agopian; Keri E Lunsford; Hans A Gritsch; Jeffrey L Veale; Gerald S Lipshutz; Hasan Yersiz; Coney L Serrone; Fady M Kaldas; Douglas G Farmer; Suphamai Bunnapradist; Gabriel M Danovitch; Ronald W Busuttil; Ali Zarrinpar Journal: Clin Transplant Date: 2019-05-07 Impact factor: 2.863
Authors: Xuanchuan Wang; Min Xu; Jianluo Jia; Zhengyan Zhang; Joseph P Gaut; Gundumi A Upadhya; Pamela T Manning; Yiing Lin; William C Chapman Journal: Am J Transplant Date: 2017-11-01 Impact factor: 8.086
Authors: Sile Yu; Jane J Long; Yifan Yu; Mary G Bowring; Jennifer D Motter; Tanveen Ishaque; Niraj Desai; Dorry L Segev; Jacqueline M Garonzik-Wang; Allan B Massie Journal: Am J Transplant Date: 2020-09-17 Impact factor: 8.086