SP3.1 80 patient series from UK renal transplant centre shows extended criteria deceased donor transplants are associated with a poorer graft function but at no increased risk of graft loss after 1 year

Abstract

Abstract Aims Between 12/2018 – 12/2021 our centre performed 163 deceased donor transplants. 30.7% of these utilised organs from so-called extended criteria donors (ECD). ECD [originally in context of donation after brain death (DBD), but later used also for donation after cardiac death (DCD)] refers to donors >60yo; or >50yo with ≥2 of hypertension / death from CVA / Cr >133. We wanted to assess outcomes in ECD transplant recipients and compare with outcomes of our standard donor (SCD) recipients. Methods Retrospective analysis of 40 ECD transplants (12/2018- 12/2021) and control group of 40 age-matched (overall mean age 58.2) SCD recipients with 12 month follow up. Results The groups were comparable regarding proportion of DCD donors (ECD 62.5%, SCD 50%; X2= 1.270 p=0.260). Although rate of delayed graft function (DGF) was higher in the ECD group, this was not statistically significant (ECD: 62.5%, SCD:47.5%; X2=1.257 p=0.262). There was, however a difference in creatinine at discharge (median ECD:390; SCD:221; U= 1018.500; p=0.036) and in EGFR at 1 year (mean ECD:39.62; SCD: 54.3; t=-3.780 p<0.001). There was no difference in incidence of graft loss (ECD:0%; SCD:2.5%; X2=1.013, p=0.314) or mortality (ECD:5.0%; SCD:7.5%; X2=0.213, p=0.644). There was no difference in index length of stay (median ECD:6; SCD: 6; U=928.000 p=0.212), or total readmissions (median ECD:2.5; SCD:2.0; U=902.500 p=0.319). Conclusions In our sample incidence of DGF was similar between the two groups. ECD recipients had poorer graft function at 1 year but there was no evidence of increased risk of graft loss at 1 year.