Similar Outcomes of Kidney Transplant Program from Controlled Cardiac Death Donors compared with Kidney Transplant from Brain Dead Donors after 2 Years of Follow Up

Abstract

REDinREN. REMAR. Material and Methods From October 2014 to October 2016, 45 cDCD kidney transplants (KT) from 30 donors and 68 KT from 52 DBD donors were performed Data regarding donors, recipients, graft and surgical details and one year outcomes were collected from cDCD and DBD, comparing both groups. Results cDCD: Donors: 60 ± 11 years, 50 % men, mean ICU stay 20 ± 11 days, 69% stroke as cause of death, creat 0.5 ± 0.2 mg / dl, proteinuria 514 ± 429 mg / day, 63.3% ECD. Very expanded criteria ( >70 years) 23% Recipients: 58 ± 13 years, 61.9% male, time of RRT 3.5 ± 2.5 years (90% Hemodialysis), 20% hypersensitized, PRA Peak 14 ± 25%, Missmatch 4 ± 1. Very ECD 20%. Total WIT 17± 4 minutes, CIT 7 ± 3 hours. No PGF, delayed graft function (DGF) 40%. BPAR 4.4%. At 1 year: Creat 1.7 ± 0.4 mg / dl, eGFR 42 ± 14 ml / min, proteinuria 467 ± 326 mg / d. At 2 years Creat 1,76 ± 0,5 mg/dl, eGFR 40 ± 14 ml / min, proteinuria 486 ± 462 mg / d. Older and male donor / recipient (ECD and Very ECD) markers of worse renal function at 2 years follow-up. Donor Hypertension and increased ICU stay markers of higher proteinuria at 6 months. cDCD vs. DBD: cDCD donors had lower creatinine (0.5 ± 0.2 vs. 0.9 ± 0.2 mg / dl) and higher proteinuria (464 ± 421 vs. 61± 95 mg / d) cDCD recipients had lower cPRA I + II peak (2.5 ± 7.5 vs. 17 ± 35%). DBD greater CIT (19.6 ± 3.9 vs. 7 ± 3 h). Thymoglobulin induction 44% DBD vs. 84% cDCD. Higher BPAR in DBD vs cDCD ( 10,9 vs. 4,4%) cDCD higher DGF (40% vs. 8.8%), no differences in creatinine, eGFR, proteinuria at 1 year. DBD higher acute rejection (11.3 vs. 4.7%), similar mortality both groups. Conclusions Successful implementation of cDCD program in numerical terms and outcomes at 2 year, similar to DBD, despite higher rate of DGF.