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Improved outcomes of renal transplantation from cardiac death donors: a 30-year single center experience.

Abstract
Outcomes of renal transplantation from donation after cardiac death (DCD) donors over 30 years were analyzed. Between 1975 and 2004, 256 renal transplantations from DCD donors were performed. The recipients were divided into four groups according to a time period as follows: 1975-1979 (Group 1; n = 18), 1980-1989 (Group 2; n = 81), 1990-1999 (Group 3; n = 84) and 2000-2004 (Group 4; n = 73). Of the 256 transplanted kidneys from DCD donors, 38 (15%) functioned immediately after transplantation. The incidence of delayed graft function (DGF) was 72%. Warm ischemic time and total ischemic time were 7.4 +/- 9.4 min and 11.9 +/- 5.6 h, respectively. The overall graft survival rates at 1, 5 and 10 years were 80%, 72% and 53%, respectively. Graft survival rates in each group have continually improved over time (5-year graft survival; 23% vs. 64% vs. 74% vs. 91%, respectively). However, there was no significant difference in graft survival rates between the groups of patients who survived with a functioning graft for more than 1 year. A multivariate Cox regression analysis showed acute rejection and donor age to be independently associated with graft outcome. DCD donors are a valuable source of kidneys for transplantation with promising long-term outcomes.
AuthorsT Tojimbara, S Fuchinoue, K Iwadoh, I Koyama, A Sannomiya, Y Kato, K Nanmoku, K Kai, I Nakajima, H Toma, S Teraoka
JournalAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 7 Issue 3 Pg. 609-17 (Mar 2007) ISSN: 1600-6135 [Print] United States
PMID17217439 (Publication Type: Journal Article)
Topics
  • Adult
  • Cadaver
  • Death
  • Delayed Graft Function (epidemiology, mortality)
  • Female
  • Graft Survival
  • Humans
  • Incidence
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Survival Rate
  • Tissue Donors
  • Tissue and Organ Procurement
  • Treatment Outcome

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