Abstract: PUB233
Outcomes in Kidney Transplantation from Increased-Risk Donor Organs: A Single-Center Experience
Session Information
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Safar-Boueri, Maria Luisa, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
- Francis, Jean M., Boston University, Boston, Massachusetts, United States
Background
Despite their lower Kidney Donor Profile Index (KDPI) score and demonstrated survival benefit of transplantation as compared with remain on dialysis, Public Health Service increased-risk donor (IRD) organs continue an underutilized source for transplantation.
Methods
This is a single-center retrospective cohort conducted at Boston Medical Center. Patients receiving IRD organs from 2016 and 2019 were evaluated. Baseline characteristics and outcomes one year after transplantation were described.
Results
We included 41 patients receiving IRD organs. Donors tended to be younger, with lower KDPI scores and good kidney function. Most common cause of death was anoxia from drug intoxication.
Patients receiving IRD organs had stable kidney function at one year, with >70% having an estimated glomerular filtration rate (eGFR) of >60 mL/min (Table 1). None of the patients became positive for HBV, HCV or HIV.
Conclusion
Patients receiving IRD organs did not show a higher risk of infection or poor renal outcomes in this single-center population.
Table 1. Donor and recipient characteristics
| Donor age (years) | 33 (23-43) |
| KDPI (mean) | 32 (sd 19) |
| Creatinine at death (mean) | 0.99 (sd 0.44) |
| Donor gender | Male 73.1% Female 26.9% |
| Donor Race | White 80% Hispanic 15% African American 5% |
| Cause of death | Anoxia 82.9% Trauma 17.1% |
| Mechanism of death | Drug intoxication 59% Cardiovascular 20% Gunshot wound 10% Blunt injury 5% Asphyxia 4% |
| DCD criteria (%) | 31 |
| Use of pump (%) | 26.8 |
| Nucleic acid test (NAT) | HCV positive 7.3% HBV 0% HIV 0% |
| Recipient age (years) | 50 (37-63) |
| Recipient race | African American 46% Hispanic 29% White 20% Unknown 5% |
| ESRD etiology | Hypertension 34.1% Glomerulopathy 21.9% Diabetes Mellitus 17% Other 17% |
| Induction therapy | Thymoglobulin 90.2% |
| Dialysis time (mean) | 4.47 years (sd 2) |
| Cold ischemia (mean) | 12 hrs (sd 4.95) |
| GFR >60 mL/min at one year (%) | 70.7 |
| Proteinuria at one year (mean) | 0.27 (sd 0.41) |
sd = standard deviation DCD = donation after cardiac death