Kidneys From Cardiac-Death, Brain-Dead Patients Equal

Graft survival, renal function similar in kidneys from both types of donor

THURSDAY, Aug. 19 (HealthDay News) -- Kidneys transplanted from donors with controlled cardiac death perform as well as organs from brain-dead donors, according to research published online Aug. 19 in The Lancet.

Dominic M. Summers, of the University of Cambridge in the United Kingdom, and colleagues analyzed data from the U.K. transplant registry on 9,134 kidney transplants, including 8,289 kidneys donated after brain death and 845 donated after controlled cardiac death. The researchers compared graft survival and long-term renal function for the two donor types.

The investigators found no difference between the two groups in graft survival up to five years or in estimated glomerular filtration rate at one to five years after transplantation in first-time transplant recipients. For those receiving kidneys after the donor's cardiac death, increasing donor and recipient age, repeat transplantation, and cold ischemic time of more than 12 hours were associated with worse graft survival. Cases in which cardiac-death donors were poorly matched to recipients for human leukocyte antigen had slightly poorer, but not statistically significant, outcomes.

"Kidneys from controlled cardiac-death donors provide good graft survival and function up to five years in first-time recipients, and are equivalent to kidneys from brain-death donors. Allocation policy for kidneys from cardiac-death donors should reduce cold ischemic time, avoid large age mismatches between donors and recipients, and restrict use of kidneys poorly matched for human leukocyte antigen in young recipients," the authors write.

Two study authors disclosed financial ties to pharmaceutical companies and manufacturers of organ preservation machines.

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