Long-Term Outcomes in Kidney Transplantation From Expanded-Criteria Donors After Circulatory Death

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• 作者：Y. Tomita^a ; ^{tomita@surgery.wisc.edu} ; T. Tojimbara^b ; K. Iwadoh^a ; I. Nakajima^a ; S. Fuchinoue^a
• 刊名：Transplantation Proceedings
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：49
• 期：1
• 页码：45-48
• 全文大小：262 K
• 卷排序：49

文摘

The number of recipients waiting for a transplant is increasing. In Japan, there is more frequent use of organs from expanded-criteria donors (ECDs) after circulatory death. We retrospectively analyzed long-term outcomes of kidney transplantation (KT) from expanded-criteria donation after circulatory death (DCD). From 1995 to 2013, 97 cases of KT from DCD donors were performed in our department. Death-censored graft survival rates of ECD kidneys (n = 50) versus standard-criteria deceased-donor (SCD) kidneys (n = 47) for 1, 5, and 10 years after transplantation were 84.0% vs 97.9%, 74.8% vs 95.6%, and 70.2% vs 81.8%, respectively. No significant difference was found between the 2 groups (P = .102). Kidneys from donors with a history of hypertension (HTN) and cerebrovascular events (CVE) and contribution from older donors had significantly lower 10-year graft survival rates (P values of .010, .036, and .050, respectively). Cox proportional hazard regression analyses showed donor age to be significantly associated with long-term graft survival independently from other factors. These results suggest that ECD kidneys remain an acceptable alternative to dialysis under certain conditions. Increased donor age was a significant risk factor determining long-term graft function. Moreover, comorbidities of HTN and CVE could become significant risk factors, especially in older donors.