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Kidney transplant outcomes from donation after circulatory death donors of advanced age
Author(s) -
Walls David O.,
LeeRiddle Grace S.,
Bover Manderski Michelle,
Sawinski Deirdre L.,
Abt Peter L.
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13881
Subject(s) - medicine , retrospective cohort study , donation , cohort , proportional hazards model , surgery , renal function , kidney , kidney transplantation , transplantation , economics , economic growth
Background Continued comparison of kidney transplant outcomes between older DCD and donation after brain death (DBD) donors is needed to safely expand the deceased donor pool. Methods We performed a retrospective cohort study using the UNOS/OPTN transplant registry from donors >50 years old between 1994 and 2016. Donor age was stratified into 4 groups: 50‐54, 55‐59, 60‐64, and >65 years old. Rates of delayed graft function (DGF) and primary non‐function (PNF) were compared. Multivariable Cox regression models were constructed to identify factors associated with time to graft failure. Results The DCD donors within each age group had fewer comorbidities than the DBD donors. Graft survival for DCD kidneys was equivalent or superior to DBD kidneys in all donor age groups. DGF rates were significantly greater for DCD kidneys in all age groups. PNF rates across all groups were similar. In multivariable analysis, DCD status was not independently associated with time to all‐cause graft failure in the 50‐54 donor age group (HR = 1.02, 95% CI = 0.93‐1.13), 55‐59 donor age group (HR = 1.07, 95% CI = 0.96‐1.19), or 60‐64 donor age group (HR = 1.135, 95% CI = 0.97‐1.32). Conclusion Kidneys from carefully selected older DCD donors, particularly ages 50‐64, are a potential means to safely expand the deceased donor pool.