David I. Harriman, Christopher J. Webb, Colleen L. Jay, Joseph Criscitiello, Jigish Vyas, Alan C. Farney, Giuseppe Orlando, Emily McCracken, Amber Reeves-Daniel, Alejandra Mena-Gutierrez, Natalia Sakhovskaya, Bobby Stratta, Robert J. Stratta
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The study purpose was to analyze our experience with kidney transplantation (KT) from DCD donors stratified by ECD versus non-ECD (standard criteria donor [SCD]).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Single center retrospective cohort study of all primary DCD KT recipients.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>From April 2003 to January 2024, we performed 671 primary DCD KTs (554 from DCD/SCDs and 117 from DCD/ECDs). Mean donor and recipient ages were 38.3 ± 14.6 DCD/SCD versus 59.4 ± 4.5 years DCD/ECD and 54.0 ± 13.1 DCD/SCD versus 63.0 ± 7.7 years DCD/ECD, respectively (both <i>p</i> < 0.05). Mean Kidney Donor Profile Index (KDPI) values were 53 ± 23% DCD/SCD versus 85 ± 9% DCD/ECD (<i>p</i> < 0.05). With a mean follow-up of 71 months DCD/SCD and 58 months DCD/ECD, patient (76.2% DCD/SCD vs. 72.6% DCD/ECD) and graft survival (61.6% DCD/SCD vs. 61.5% DCD/ECD) rates were comparable. Rates of primary nonfunction/thrombosis and delayed graft function were 3.4% for both DCD/SCD and DCD/ECD and 49% DCD/SCD versus 56% DCD/ECD, respectively (both <i>p</i> = NS). The presence of DGF did not influence survival outcomes in DCD/ECD KTs whereas inferior graft survival was noted in DCD/SCD KTs with DGF. However, DGF did have a negative effect on renal function in all groups. DCD/ECD KTs with or without DGF had comparable outcomes to DCD/SCD KTs with DGF.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>DCD/ECD KTs are associated with inferior functional but similar mid-term survival outcomes compared to DCD/SCD KTs with DGF. The presence of DGF appears to have a differential effect on survival outcomes in these two groups.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 6","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Experience With 117 Donation After Circulatory Death Expanded Criteria Donor Kidney Transplants: What Are the Limits of Acceptability?\",\"authors\":\"David I. Harriman, Christopher J. Webb, Colleen L. Jay, Joseph Criscitiello, Jigish Vyas, Alan C. Farney, Giuseppe Orlando, Emily McCracken, Amber Reeves-Daniel, Alejandra Mena-Gutierrez, Natalia Sakhovskaya, Bobby Stratta, Robert J. 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Mean Kidney Donor Profile Index (KDPI) values were 53 ± 23% DCD/SCD versus 85 ± 9% DCD/ECD (<i>p</i> < 0.05). With a mean follow-up of 71 months DCD/SCD and 58 months DCD/ECD, patient (76.2% DCD/SCD vs. 72.6% DCD/ECD) and graft survival (61.6% DCD/SCD vs. 61.5% DCD/ECD) rates were comparable. Rates of primary nonfunction/thrombosis and delayed graft function were 3.4% for both DCD/SCD and DCD/ECD and 49% DCD/SCD versus 56% DCD/ECD, respectively (both <i>p</i> = NS). The presence of DGF did not influence survival outcomes in DCD/ECD KTs whereas inferior graft survival was noted in DCD/SCD KTs with DGF. However, DGF did have a negative effect on renal function in all groups. DCD/ECD KTs with or without DGF had comparable outcomes to DCD/SCD KTs with DGF.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>DCD/ECD KTs are associated with inferior functional but similar mid-term survival outcomes compared to DCD/SCD KTs with DGF. 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Experience With 117 Donation After Circulatory Death Expanded Criteria Donor Kidney Transplants: What Are the Limits of Acceptability?
Introduction
Nonuse of expanded criteria donor (ECD) kidneys from donation after cardiocirculatory death (DCD) donors remains high. The study purpose was to analyze our experience with kidney transplantation (KT) from DCD donors stratified by ECD versus non-ECD (standard criteria donor [SCD]).
Methods
Single center retrospective cohort study of all primary DCD KT recipients.
Results
From April 2003 to January 2024, we performed 671 primary DCD KTs (554 from DCD/SCDs and 117 from DCD/ECDs). Mean donor and recipient ages were 38.3 ± 14.6 DCD/SCD versus 59.4 ± 4.5 years DCD/ECD and 54.0 ± 13.1 DCD/SCD versus 63.0 ± 7.7 years DCD/ECD, respectively (both p < 0.05). Mean Kidney Donor Profile Index (KDPI) values were 53 ± 23% DCD/SCD versus 85 ± 9% DCD/ECD (p < 0.05). With a mean follow-up of 71 months DCD/SCD and 58 months DCD/ECD, patient (76.2% DCD/SCD vs. 72.6% DCD/ECD) and graft survival (61.6% DCD/SCD vs. 61.5% DCD/ECD) rates were comparable. Rates of primary nonfunction/thrombosis and delayed graft function were 3.4% for both DCD/SCD and DCD/ECD and 49% DCD/SCD versus 56% DCD/ECD, respectively (both p = NS). The presence of DGF did not influence survival outcomes in DCD/ECD KTs whereas inferior graft survival was noted in DCD/SCD KTs with DGF. However, DGF did have a negative effect on renal function in all groups. DCD/ECD KTs with or without DGF had comparable outcomes to DCD/SCD KTs with DGF.
Conclusions
DCD/ECD KTs are associated with inferior functional but similar mid-term survival outcomes compared to DCD/SCD KTs with DGF. The presence of DGF appears to have a differential effect on survival outcomes in these two groups.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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