Epidemiology of Kidney Discard from Expanded Criteria Donors Undergoing Donation after Circulatory Death

The broader use of combined expanded criteria donor and donation after circulatory death (ECD/DCD) kidneys may help expand the deceased donor pool. The purpose of our study was to evaluate discard rates of kidneys from ECD/DCD donors and factors associated with discard. ECD/DCD donors and kidneys we...

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Bibliographic Details
Published in:Clinical journal of the American Society of Nephrology 2016-02, Vol.11 (2), p.317-323
Main Authors: Singh, Sunita K, Kim, S Joseph
Format: Article
Language:English
Subjects:
Aged
Cause of Death
Donor Selection
Female
Graft Survival
Humans
Kaplan-Meier Estimate
Kidney Transplantation - adverse effects
Kidney Transplantation - methods
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Original
Registries
Risk Assessment
Risk Factors
Time Factors
Tissue and Organ Procurement
Tissue Donors - supply & distribution
Treatment Outcome
United States
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Summary:The broader use of combined expanded criteria donor and donation after circulatory death (ECD/DCD) kidneys may help expand the deceased donor pool. The purpose of our study was to evaluate discard rates of kidneys from ECD/DCD donors and factors associated with discard. ECD/DCD donors and kidneys were evaluated from January 1, 2000 to March 31, 2011 using data from the Scientific Registry of Transplant Recipients. The kidney donor risk index was calculated for all ECD/DCD kidneys. Multivariable logistic regression models were used to determine risk factors for discarding both donor kidneys. The Kaplan-Meier product limit method and the log-rank statistic were used to assess the cumulative probability of graft failure for transplants from ECD/DCD donors where the mate kidney was discarded versus both kidneys were used. There were 896 ECD/DCD donors comprising 1792 kidneys. Both kidneys were discarded in 44.5% of donors, whereas 51.0% of all available kidneys were discarded. The kidney donor risk index scores were higher among donors of discarded versus transplanted kidneys (median, 1.82; interquartile range, 1.60, 2.07 versus median, 1.67; interquartile range, 1.49, 1.87, respectively; P
ISSN:1555-9041
1555-905X
DOI:10.2215/CJN.07190715