The differential impact of early graft dysfunction in kidney donation after brain death and after circulatory death: Insights from the Dutch National Transplant Registry.

• Tác giả: Marije C Baas, Frederike J Bemelman, Maarten H L Christiaans, Aiko P J de Vries, Lara Evers, Jesper Kers, Jan H N Lindeman, Hessel Peters-Sengers, Janneke A J Rood, Jan-Stephan F Sanders, Thei S Steenvoorden, Arjan D van Zuilen, Liffert Vogt
• Ngôn ngữ: eng
• Ký hiệu phân loại: 236.2 Future state (Life after death)
• Thông tin xuất bản: United States : American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons , 2025
• Bộ sưu tập: NCBI
• ID: 215400

Tóm tắt

 Kidneys donated after circulatory death (DCD) perform similarly to kidneys donated after brain death (DBD). However, the respective incidences of delayed graft function (DGF) differ. This questions the donor type-specific impact of early graft function on long-term outcomes. Using competing risk and Cox-regression analysis, we compared death-censored graft loss between types of early graft function: DGF (temporary dialysis dependency started within 7 days after transplantation), slow graft function (3-day plasma creatinine decline less than 10% per day), and immediate graft function. In 1061 DBD and 1605 DCD graft recipients (January 2014 until January 2023), graft survival was similar. DGF was associated with death-censored graft loss in DBD and DCD (adjusted hazard ratios: DGF in DBD: 1.79 [1.04-2.91], P = .027, DGF in DCD: 1.84 [1.18-2.87], P = .008
  Reference: no DGF). Slow graft function was associated with death-censored graft loss in DBD, but not significantly in DCD (adjusted hazard ratios DBD: 2.82 (1.34-5.93), P = .007, and DCD: 1.54 (0.72-3.35), P = .262
  Reference: immediate graft function). Early graft dysfunction has a differential impact on graft outcome in DBD and DCD. The differences between DBD and DCD should be accounted for in research and the clinic.