DOES DONOR SERUM CREATININE IN DONATION AFTER CARDIAC DEATH CASES IMPACT THE LONG TERM OUTCOME IN KIDNEY TRANSPLANTATION?

In Japan, we have experienced 2,746 kidney transplants from donation after cardiac death (DCD) cases from April 1995 to December 2013. Most DCDs in Japan are donors awaiting cardiac arrest without withdrawal of the ventilator, resulting in prolonged hypotension, prolonged anuria and elevated serum creatinine (sCr) levels prior to cardiac arrest. The 2,746 DCD kidney transplants performed from April 1995 to December 2013 in multiple centers in Japan were included in this study. The long term outcome of patient and graft survival rates in correlation with donor-admission and pre-recovery donor sCr levels were analyzed with a Kaplan-Meier model. Log-rank and Wilcoxon tests were used to evaluate differences in the survival curves of different groups. Donor-admission and pre-recovery sCr levels in DCD cases did not have a significant impact in the patient and graft survival rate in kidney transplantation. The limitation in this study is that the kidneys from donors with elevated sCr may not be recovered or utilized.