The deceased donor score system in kidney transplants from deceased donors after cardiac death.

Journal article

SUMMARY: A clinical score to identify kidneys from donors after cardiac death (DCD) with a high risk of dysfunction following transplantation could be a useful tool to guide the introduction of new algorithms for the preservation of these organs and improve their outcome after transplantation. We investigated whether the deceased donor score (DDS) system could identify DCD kidneys with higher risk of early post-transplant dysfunction. The DDS was validated in a cohort of 168 kidney transplants from donors after brain death (DBD) and then applied to a cohort of 56 kidney transplants from DCD. In the DBD cohort, the DDS grade predicted the incidence of delayed graft function (DGF) and levels of serum creatinine at 3 and 12 months post-transplant. Similarly, in the DCD cohort, the DDS grade correlated with DGF and also predicted the levels of serum creatinine at 3 and 12 months. Interestingly, the DDS identified a subgroup of marginal DCD kidneys in which minimization of cold ischemia time produced better early clinical outcome. These results highlight the impact of early interventions on clinical outcome of marginal DCD kidneys and open the possibility of using the DDS to identify those kidneys that may benefit most from therapeutic interventions before transplantation.

Authors: Plata-Munoz, J; Vazquez-Montes, M; Friend, P; Fuggle, S

• Publication status: Published
• Journal: Transplant international : official journal of the European Society for Organ Transplantation
• Volume: 23
• Issue: 2
• Pages: 131-139
• Publication date: 2010-02-01
• DOI: 10.1111/j.1432-2277.2009.00951.x
• EISSN: 1432-2277
• ISSN: 0934-0874
• Language: English
• Keywords: Kidney Transplantation; Middle Aged; Humans; Cohort Studies; Delayed Graft Function; Death; Female; Tissue Donors; Treatment Outcome; Male; Creatinine; Graft Survival; Survival Analysis; Aged; Algorithms; Time Factors; Adult; Young Adult