• Francisco Del Río, Amado Andrés, María Padilla, Ana I Sánchez-Fructuoso, María Molina, Ángel Ruiz, José M Pérez-Villares, Lorena Z Peiró, Teresa Aldabó, Rosa Sebastián, Eduardo Miñambres, Lidia Pita, Marcial Casares, Juan Galán, Cristina Vidal, Christel Terrón, Pablo Castro, Marga Sanroma, Elisabeth Coll, Beatriz Domínguez-Gil, and Spanish Group for the Study of Donation after Circulatory Death.
• Hospital Clínico San Carlos, Madrid, Spain.
• Kidney Int. 2019 Feb 1; 95 (2): 420-428.

AbstractDonation after uncontrolled circulatory death (uDCD) refers to donation from persons who have died following cardiac arrest and unsuccessful attempt at resuscitation. We report the Spanish experience of uDCD kidney transplantation, and identify factors related to short-term post-transplant outcomes. The Spanish CORE system compiles data on all donation and transplant procedures in the country. Between 2012-2015, 517 kidney transplants from 288 uDCD donors were performed. The incidence of primary non-function was 10%, and the incidence of delayed graft function was 76%. One-year death-censored graft survival was 87%. In a Cox-Model, donor age ≥ 60 years (odds ratio [OR] 2.7; 95% confidence interval [CI] 1.2-6.1), in situ cooling of kidneys versus normothermic regional perfusion (OR 5.6; 95% CI 2.7-11.5) or hypothermic regional perfusion based on the use of extracorporeal membrane oxygenation devices (OR 4.3; 95% CI 2.1-8.6), and a recipient history of prior kidney transplant (OR 3.5; 95% CI 1.5-8.3) all significantly increased the risk of graft loss during the first year after transplantation. Kidney transplantation from uDCD donors provides acceptable 1-year outcomes, although there is room for improvement. Hypothermic and normothermic regional perfusion strategies are preferable to in situ cooling of kidneys from uDCD donors.Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

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