Similar Outcomes of Kidney Transplant Program from Controlled Cardiac Death Donors compared with Kidney Transplant from Brain Dead Donors after 2 Years of Follow Up

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Abstract

Material and Methods

From October 2014 to October 2016, 45 cDCD kidney transplants (KT) from 30 donors and 68 KT from 52 DBD donors were performed

Material and Methods

Data regarding donors, recipients, graft and surgical details and one year outcomes were collected from cDCD and DBD, comparing both groups.

Results

cDCD: Donors: 60 ± 11 years, 50 % men, mean ICU stay 20 ± 11 days, 69% stroke as cause of death, creat 0.5 ± 0.2 mg / dl, proteinuria 514 ± 429 mg / day, 63.3% ECD. Very expanded criteria ( >70 years) 23%

Results

Recipients: 58 ± 13 years, 61.9% male, time of RRT 3.5 ± 2.5 years (90% Hemodialysis), 20% hypersensitized, PRA Peak 14 ± 25%, Missmatch 4 ± 1. Very ECD 20%.

Results

Total WIT 17± 4 minutes, CIT 7 ± 3 hours. No PGF, delayed graft function (DGF) 40%. BPAR 4.4%. At 1 year: Creat 1.7 ± 0.4 mg / dl, eGFR 42 ± 14 ml / min, proteinuria 467 ± 326 mg / d. At 2 years Creat 1,76 ± 0,5 mg/dl, eGFR 40 ± 14 ml / min, proteinuria 486 ± 462 mg / d.

Results

Older and male donor / recipient (ECD and Very ECD) markers of worse renal function at 2 years follow-up. Donor Hypertension and increased ICU stay markers of higher proteinuria at 6 months.

Results

cDCD vs. DBD: cDCD donors had lower creatinine (0.5 ± 0.2 vs. 0.9 ± 0.2 mg / dl) and higher proteinuria (464 ± 421 vs. 61± 95 mg / d)

Results

cDCD recipients had lower cPRA I + II peak (2.5 ± 7.5 vs. 17 ± 35%).

Results

DBD greater CIT (19.6 ± 3.9 vs. 7 ± 3 h). Thymoglobulin induction 44% DBD vs. 84% cDCD.

Results

Higher BPAR in DBD vs cDCD ( 10,9 vs. 4,4%)

Results

cDCD higher DGF (40% vs. 8.8%), no differences in creatinine, eGFR, proteinuria at 1 year.

Results

DBD higher acute rejection (11.3 vs. 4.7%), similar mortality both groups.

Conclusions

Successful implementation of cDCD program in numerical terms and outcomes at 2 year, similar to DBD, despite higher rate of DGF.

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