Abstract: FR-PO1032
Long-Term Outcomes of Kidney Transplantation Using Non Conventional Donors
Session Information
- Transplantation: Donor-Candidate Assessment and Predictors of Outcome
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
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)
| NCD | SCD | p value | |
| 1 year | 55 ± 19.5 | 63 ± 20.8 | p < 0.001 |
| 3 years | 56 ± 19.1 | 65 ± 22.9 | p < 0.001 |
| 5 years | 56 ± 22.6 | 64 ± 24.1 | p < 0.001 |
| 7 years | 55 ± 23.2 | 67 ± 23.3 | p < 0.001 |
Funding
- Clinical Revenue Support