Highlights
- •Ten-year graft and patient survival similar between uDCD and cDCD kidney allografts.
- •uDCD kidney allograft recipients experienced higher rates of primary non-function.
- •uDCD is a viable source of kidney allografts amid shortages in the US organ pool.
Abstract
Background
Compared to controlled donation after cardiac death (cDCD), uncontrolled DCD (uDCD)
kidney transplantation remains an underutilized resource in the United States. However,
it is unclear whether long-term allograft outcomes following uDCD are inferior to
that of cDCD kidney transplantation.
Methods
From January 1995 to January 2018, the OPTN/UNOS database was queried to discover
all reported cases of uDCD and cDCD kidney transplantation. Primary non-function,
delayed graft function, ten-year graft and patient survival were compared among uDCD
and cDCD patients.
Results
Rates of primary non-function (4.0% [uDCD] vs. 1.8% [cDCD], P < 0.001) and delayed
graft function (51.1% [uDCD] vs. 41.7% [cDCD], P < 0.001) were higher following uDCD
transplant. However, ten-year graft survival (47.5% [uDCD] vs. 48.4% [cDCD], P = 0.21)
and patient survival were similar to cDCD transplantation (59.4% [uDCD] vs. 59.2%
[cDCD], P = 0.32).
Conclusion
Although initial allograft outcomes are inferior following uDCD, long-term durability
of uDCD kidney allografts is on par to cDCD transplantation. Kidney allografts derived
by uDCD may be a viable and durable option to increase the donor pool.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: December 19, 2022
Accepted:
December 19,
2022
Received in revised form:
November 22,
2022
Received:
September 14,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
☆This study was presented at the American Transplant Congress, June 1–5 2019, Boston, Massachusetts.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
