Kidney transplantation from brain and cardiac death donors and immunosuppression: a single-center experience

Abstract

Objective To investigate the experience of kidney transplantation from brain and cardiac death donors(donation after brain plus cardiac death, DBCD)and clinical effect of immunosuppressive regimen. Methods A retrospective analysis of kidney transplantation from DBCD in our hospital from September 2011 to August 2015 was performed. All patients were treated with double doses Basiliximab to inductive immune, and then treated with prednisone(Pre) , mycophenolate mofetil (MMF) , Tacrolimus (FK506). During the follow-up of 1 year, acute rejection, incidence of delayed graft function (DGF), patient's survival and graft survival rates, complication and clinical adverse events and laboratory test results were evaluated. Results In the 80 cases, the actuarial patient and grafts' survival rates at 1, 3, 6 and 12 months after transplantation was 100.0%(100/100), 100.0%(100/100), 98.7%(79/80), 97.5%(78/80) and 97.5%(78/80), 97.5%(78/80), 96.2%(77/80), 95.0%(76/80) respectively.DGF occurred in 13 of 80 (16.3%) , but the occurrence of DGF did not adversely influence patient’s survival (P=0.525) or graft survival (P=0.372). Five cases of acute rejection appeared(6.3%)and the primary non-functioning kidney was not occurred in all patients. Five cases of urinary tract infection during perioperative period, abdominal infection in 2 cases, herpes simplex infection in 2 cases were found. Conclusions DBCD is an important means to solve the shortage of organs in our country, it opens up a new way to expand the source of donor kidney.The combined use of two doses of Basiliximab for inductiving immune combination with Pre, MMF, FK506 immunosuppressive regimen can effctively reduce the incidence of acute rejection, the safety and tolerance are better. Key words: Kidney Transplantation; Brain Death