Followup and Outcome of Renal Transplant Patients with Deceased after Cardiac Death Donors (DCD)

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Introduction: Renal transplantation is the best cost effective treatment for end-stage renal failure and improves quality of life, when compared with dialysis. Prior to the introduction, in the mid 1970s of legislation defining the diagnosis of brain-stem death, transplant organs were removed from DCD. Despite renewed interest in DCD kidney transplantation, very few clinical programmes have been developed this type of grafting. We analyzed the function and outcome of kidney transplants performed from DCD in our hospital. Patients and methods: From 1999 until december 2011, 35 patients were grafted with kidneys from DCD. This group was compared with recipients of standard criteria donors (SCD) matched for age, sex, number of transplants and HLA. Immunosupression was performed with Basiliximab, Predinisone, Tacrolimus and Micophenolate Mofetil. Acute rejection episodes were treated with Methylprednisolone boluses, and ATG-FRESENIUS® when necessary. Results: The delayed graft function rate was higher on DCD transplants than in SCD graft. Serum creatinine levels was significantly better in the DCD, 1.5 mg/dl versus 1.75 mg/dl. Graft survival at 5 year was 84% in DCD and 85% in SCD. Patient survival in both groups was 100%. Patients grafted with DCD were hospitalized longer and needed more dialysis. Acute rejection episodes were more frequent in DCD. Conclusion: This source of kidneys has evidence of equivalent graft function and survival, compared with SCD and may contribute to expand de donor pool