How LUCAS® device affects kidney transplant rate in a “donors after circulatory death” program

Abstract

Pilar Palma1, Angel Ruiz2, Francesc Carmona1,∗, Ramon Soliba2, Elisabet Barrau3, David Paredes2 1 Sistema d’Emergencies Mediques, Catalonia, Spain 2 Donation Unit, Hospital Clinic, Barcelona, Spain 3 ABS Montclar, ICS, Sant Boi de Llobregat, Spain Purpose: To analyze how LUCAS® device has affected kidney transplant rate in a “donor after circulatory death” program (DACDP) and to describe donors’ characteristics after 10 years of the program start. Methods: A prospective analytic study was performed from January 2002 to December 2011. From all the potential donors in a DACDP, all those who finally accomplished the program criteria were entered in NECMO and were not rejected by other causes different than those related to perfusion. Studied variables were: donors’ sex, age, body mass index (BMI) and presence of cardio-circulatory risk factors (CCRF), total out-of-hospital CPR time (OHCPR), kidney transplantation and use of LUCAS® device. Qualitative data are presented as percents and compared with Chi square test. Quantitative data are presented as mean and standard deviation and compared with Student’s T test. A logistical regression model was performed to adjust the LUCAS® effect over transplantation by possible confounding factors. Results: From the 160 potential donors, 97 accomplished the study criteria. 91.8% (89) weremales. Themean age was 47.8 years (SD=12.3), mean BMI was 27.1 kg/m2 (SD=4), and mean OHCPR was 60.3min (SD=17.8). 48.5% (47) had CCRF and LUCAS was used in 52.6% of patients (51). 144 out of 194 kidneyswere transplanted. LUCAS® was associated with an increase of the transplant rate in a 13% (CI 95%=0.7–25) (p=0.039). Lower mean age and BMI were also associated with an increase of the transplant rate (p=0.004 and0.001). Noother significant statistical associationwas observed but a trend in lower OHCPRmean (p=0.145). After adjusting LUCAS effect by donors age and BMI, OHCPR and their first order interactions in a logistic regression model, the use of LUCAS® multiplies by 1.9 the transplantation odds (CI 95%=0.94–3.8). Conclusions: The use of LUCAS® increases the number of transplanted kidneys when used in a DACDP.