Abstract
Purpose: Donation after Circulatory Death (DCD) renal allografts continue to be an under-utilized organ source. While DCD grafts have comparable outcomes to neurological determination of death (NDD) grafts, the impact of donor age has been addressed in only a limited number of studies. The aim of our study is to compare patient outcome in recipients of DCD allografts from donors greater than 50 years of age to those 50 years of age and younger. Methods: Institutional review board approved our study. 118 kidney transplant recipients received DCD allografts at our institution between July 2006 and September 2013. Recipient outcome variables (creatinine clearance (CrCl), readmission rate, length of hospital stay (LOS), or delayed graft function (DGF) ) were compared for donors older than age 50 and 50 years of age or less. Student t-test and Pearson chi-square test were used in analysis. Results: Mean recipient age was 43.4 years (SD =14.5) and median follow-up was 20.5 months (range 1.1 to 86.6). Recipients of kidney transplants from DCD donors 51 years of age and older demonstrated lower CrCl at 1 month (50.3 mL/min vs. 72.7 mL/min, p<0.001), 3 months (62.5 mL/min vs 87.9 ml/min, p = 0.002), and 1 year (66.2 mL/min vs 87.8 mL/min, p = 0.013). The two groups did not differ with regard to delayed graft function χ2 =0.573, p = 0.706, graft loss χ2 = 0.779, p = 1.00, or hospital readmission χ2 = 0.294, p = 0.355. Hospital LOS was equivalent between the two groups (13.9 days vs. 13.8 days, p = 0.929). Recipients of older DCD kidneys (>50 years of age) tended to be older (59.2 vs. 49.3, p <0.001). Conclusions: Recipients of DCD kidneys had similar short-term outcomes (DGF, LOS) between the two age categories. Recipients of the allografts from donors greater than 50 years of age demonstrated lower creatinine clearance at one year. Longer follow-up is required to determine long-term survival of these allografts.
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