Kidney Allograft Outcomes of Dual‐Organ Heart Kidney Transplant Recipients Following Donation After Circulatory Determination of Death

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Hauptverfasser: Ananya Gorrai, Aparajith Kannapiran, Maryjane Farr, David Wojciechowski, Christopher Wrobel, Swee‐Ling Levea, Nicholas Hendren, Natalie Tapaskar, Elizabeth Ashley Hardin, Hadi Beaini, Jaye Alexander Weston, Christopher Heid, Matthias Peltz, Lauren K. Truby
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author Ananya Gorrai
Aparajith Kannapiran
Maryjane Farr
David Wojciechowski
Christopher Wrobel
Swee‐Ling Levea
Nicholas Hendren
Natalie Tapaskar
Elizabeth Ashley Hardin
Hadi Beaini
Jaye Alexander Weston
Christopher Heid
Matthias Peltz
Lauren K. Truby
author_facet Ananya Gorrai
Aparajith Kannapiran
Maryjane Farr
David Wojciechowski
Christopher Wrobel
Swee‐Ling Levea
Nicholas Hendren
Natalie Tapaskar
Elizabeth Ashley Hardin
Hadi Beaini
Jaye Alexander Weston
Christopher Heid
Matthias Peltz
Lauren K. Truby
Ananya Gorrai
Aparajith Kannapiran
Maryjane Farr
David Wojciechowski
Christopher Wrobel
Swee‐Ling Levea
Nicholas Hendren
Natalie Tapaskar
Elizabeth Ashley Hardin
Hadi Beaini
Jaye Alexander Weston
Christopher Heid
Matthias Peltz
Lauren K. Truby
collection Wiley Open Access
contents Kidney Allograft Outcomes of Dual‐Organ Heart Kidney Transplant Recipients Following Donation After Circulatory Determination of Death Ananya Gorrai Aparajith Kannapiran Maryjane Farr David Wojciechowski Christopher Wrobel Swee‐Ling Levea Nicholas Hendren Natalie Tapaskar Elizabeth Ashley Hardin Hadi Beaini Jaye Alexander Weston Christopher Heid Matthias Peltz Lauren K. Truby Clinical Transplantation ABSTRACT Introduction Simultaneous Heart‐Kidney Transplantation (SHKT) following donation after circulatory determination of death (DCD) is increasing. Whether kidney allograft outcomes differ from donation after brain death (DBD) SHKT recipients has not been well studied. Methods We identified adults in the UNOS database who were listed for SHKT and transplanted after 2018. Baseline characteristics of DBD and DCD recipients and donors were compared. Outcomes of interest included primary nonreceipt of a kidney allograft, acute post‐transplant dialysis, and chronic dialysis or renal transplantation. Survival to 1‐year and renal allograft function at follow up were also assessed. Univariate and multivariable logistic regression were used to identify risk factors for the individual outcomes with Cox proportional hazard modeling leveraged to identify risk factors for 1‐year mortality. One‐year survival was compared between both groups using Kaplan‐Meier and Cox‐Hazards ratio. Results From October 18, 2018 to December 31, 2023, there were 1956 SHKT recipients, with 1828 receiving allografts from DBD donors and 128 from DCD donors. DCD recipients were significantly older, listed at lower transplant status, and less likely to be on inotropic or intra‐aortic balloon pump support before transplant. DCD donors were younger and had higher baseline eGFR. After a median follow‐up of 847 days, there was no significant difference in renal allograft outcomes between groups. There was no difference in 1‐year survival between DCD and DBD SHKT recipients, and DCD status was not associated with 1‐year survival after adjustment for key donor and recipient characteristics. Conclusion Kidney allograft outcomes are similar in DBD and DCD SHKT recipients, which supports DCD in expanding the donor pool for SHKT candidates. 10.1111/ctr.70456 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/ctr.70456
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publisher Wiley
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spellingShingle Kidney Allograft Outcomes of Dual‐Organ Heart Kidney Transplant Recipients Following Donation After Circulatory Determination of Death
Ananya Gorrai
Aparajith Kannapiran
Maryjane Farr
David Wojciechowski
Christopher Wrobel
Swee‐Ling Levea
Nicholas Hendren
Natalie Tapaskar
Elizabeth Ashley Hardin
Hadi Beaini
Jaye Alexander Weston
Christopher Heid
Matthias Peltz
Lauren K. Truby
Clinical Transplantation
Kidney Allograft Outcomes of Dual‐Organ Heart Kidney Transplant Recipients Following Donation After Circulatory Determination of Death Ananya Gorrai Aparajith Kannapiran Maryjane Farr David Wojciechowski Christopher Wrobel Swee‐Ling Levea Nicholas Hendren Natalie Tapaskar Elizabeth Ashley Hardin Hadi Beaini Jaye Alexander Weston Christopher Heid Matthias Peltz Lauren K. Truby Clinical Transplantation ABSTRACT Introduction Simultaneous Heart‐Kidney Transplantation (SHKT) following donation after circulatory determination of death (DCD) is increasing. Whether kidney allograft outcomes differ from donation after brain death (DBD) SHKT recipients has not been well studied. Methods We identified adults in the UNOS database who were listed for SHKT and transplanted after 2018. Baseline characteristics of DBD and DCD recipients and donors were compared. Outcomes of interest included primary nonreceipt of a kidney allograft, acute post‐transplant dialysis, and chronic dialysis or renal transplantation. Survival to 1‐year and renal allograft function at follow up were also assessed. Univariate and multivariable logistic regression were used to identify risk factors for the individual outcomes with Cox proportional hazard modeling leveraged to identify risk factors for 1‐year mortality. One‐year survival was compared between both groups using Kaplan‐Meier and Cox‐Hazards ratio. Results From October 18, 2018 to December 31, 2023, there were 1956 SHKT recipients, with 1828 receiving allografts from DBD donors and 128 from DCD donors. DCD recipients were significantly older, listed at lower transplant status, and less likely to be on inotropic or intra‐aortic balloon pump support before transplant. DCD donors were younger and had higher baseline eGFR. After a median follow‐up of 847 days, there was no significant difference in renal allograft outcomes between groups. There was no difference in 1‐year survival between DCD and DBD SHKT recipients, and DCD status was not associated with 1‐year survival after adjustment for key donor and recipient characteristics. Conclusion Kidney allograft outcomes are similar in DBD and DCD SHKT recipients, which supports DCD in expanding the donor pool for SHKT candidates. 10.1111/ctr.70456 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Kidney Allograft Outcomes of Dual‐Organ Heart Kidney Transplant Recipients Following Donation After Circulatory Determination of Death
topic Clinical Transplantation
url https://onlinelibrary.wiley.com/doi/10.1111/ctr.70456