Abstract: FR-PO1032

Long-Term Outcomes of Kidney Transplantation Using Non Conventional Donors

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Francalacci, Luis C, University of California, Davis, Sacramento, California, United States
  • Chen, Ling-Xin, University of California, Davis, Sacramento, California, United States
  • Perez, Richard V., University of California, Davis, Sacramento, California, United States
  • De Mattos, Angelo M., University of California, Davis, Sacramento, California, United States
Background

With the donor-recipient gap widening the pressure to utilize more non-conventional deceased donors (NCD) has increased. However, analysis of long term outcomes of such transplants is lacking. We described our experience with NCD over the past decade.

Methods

We included all deceased donor transplants performed at our center between 2005 and 2013 using donors with cardiac death, dual grafts, extended criteria, and with acute kidney injury: the NCD group. We compared their graft survival (Kaplan-Meier and Cox-regression) and renal function (MDRD eGFR) with our standard criteria donor (SCD) cohort.

Results

Of all 996 adult deceased donors transplants 459 were NCD and 537 were SCD. The groups were not different in terms of gender, race, dialysis or HCV exposure, type of insurance, and BMI at transplant,
The NCD group was older and had more diabetics, PRA was lower and less re-transplants. More often their kidneys came from older donors, were non-local, had a longer cold ischemic time, placed on pulsatile perfusion, and donor death by CVA (p<.001, all comparisons).
Death censored graft survival was not different between groups (fig 1). After adjusting for all significant variables only age of recipients (p=.02) and donors with CVA (p=.002) were significant factors for graft failure. Renal function was lower on the NCD group at all time points. However, the eGFR was stable (and above 50 ml/min) within the groups for up to 7 years (table 1).

Conclusion

The use of NCD kidneys resulted in similar long term outcomes in terms of graft survival and function, as compared to SCD. The nephrology community and their patients should be aware of the benefits of accepting these grafts.

Graft function (e-GFR, mean ± SD)
 NCDSCDp value
1 year55 ± 19.563 ± 20.8p < 0.001
3 years56 ± 19.165 ± 22.9p < 0.001
5 years56 ± 22.664 ± 24.1p < 0.001
7 years55 ± 23.267 ± 23.3p < 0.001

Funding

  • Clinical Revenue Support