Kidney donation after cardiac death

Table 1 Maastricht classification of donation after cardiac death

Maastricht category	Description
I	Dead on arrival at hospital
II	Unsuccessful resuscitation
III	Awaiting death by cardiovascular arrest
IV	Death by cardiovascular arrest during or after brain death diagnostic procedure
V	Unexpected cardiac arrest in a critically ill patient

Table 2 Comparison of the outcome of renal transplantation from controlled and uncontrolled donation after cardiac death

Series	Type/number	Patient survival (%)	Graft survival (%)	DGF (%)	PNF (%)	Comments
Gagandeep et al[7] 2006 (1995-2004)	UC 216	93 (1-yr) 84 (5-yr)	85 (1-yr) 72 (5-yr)	51	2.8	UNOS data
	C 1814	95 (1-yr) 83 (5-yr)	88 (1-yr) 67 (5-yr)	42	1.8	Comparable survival between groups
Hoogland et al[19] 2011 (1981-2008)	UC 128	61 (10-yr)	50 (10-yr)	61	22	Pioneering centre for DCD
	C 208	60 (10-yr)	46 (10-yr)	56	21
Dominguez-Gil et al[61] 2011 (2000-2008)	UC 649		88.9 (1-yr)	75.7	6.4	Higher DGF for UC
	C 2343		85.9 (1-yr)	50.2	5

DCD: Donation after cardiac death; DGF: Delayed graft function; PNF: Primary non function; UC: Uncontrolled DCD; C: Controlled DCD.

Table 3 Comparison of the outcome of renal transplantation from donation after cardiac and brain dead donors

Series	Type number	Patient survival (%)	Graft survival (%)	DGF (%)	PNF (%)	AR (%)	Comments
Gagandeep et al[7] 2006 (1995-2004)	DCD 2136	95 (1-yr) 83 (5-yr)	87 (1-yr) 68 (5-yr)	40.8	1.8		UNOS data
	DBD 75865	95 (1-yr) 84 (5-yr)	88 (1-yr) 66 (5-yr)	24	1.4		No difference in long term survival
Akoh et al[12] 2009 (2005-2008)	DCD 57	93	88	44	0	15.8	Conversion rate of 44%. Outcome of DCD equivalent with DBD
	DBD 58	96	93	14	11.7	27.6
Sanchez-Fructuoso et al[55] 2000 (1989-1998)	DCD 95	Equivalent	84 (1-yr) 82.7 (5-yr)	5.73 ×			90 donors were out of hospital arrests. Of these, 54 transplants had primary function
	DBD 354		87.5 (1-yr) 83.9 (5-yr)	1 ×
Farney et al[64] 2008 (2003-2007)	DCD 53	94	87	57		19	Incidence of DGF was 57% (60% without vs 20% with extracorporeal support, P = 0.036)
	DBD 316	Similar	Similar	19		10
Sanchez-Fructuoso et al[65] 2004 (1990-1998)	DCD 83		97 (2-yr) 84 (6-yr)	58.8			Cr at 3 and 12 mo better for DCD. DGF is a risk factor for worse graft outcome in DBD but not DCD
	DBD 3177		97 (2-yr) 84 (6-yr)	28.9
Wijnem et al[66] 1995	DCD 57	75(5-yr)	54 (5-yr)	60	14		No difference in graft or patient survival at 5 yr
	DBD 114	77 (5-yr)	55 (5-yr)	35	8
Locke et al[67] 2007 (1993-2005)	DCD 2562		79.9(5-yr)	38.7	1.6		DCD < 50 yr function like SCD. Limiting CIT to < 12 h reduces DGF by 15%
	DBD 62800		77.9 (5-yr)	19.5	0.7
Pine et al[68] 2010 (2002-2007)	DCD 103	98 (1-yr) 95 (3-yr)	97 (1-yr) 92 (3-yr)	58	4	12	DCD has poorer early graft function but equivalent long term function
	DBD 183	97 (1-yr) 96 (3-yr)	96 (1-yr) 95 (3-yr)	22	1	16
Summers et al[69] 2010 (2000-2008)	DCD 748	86.4 (5-yr)	85.1 (5-yr)	46.7	2.7	16	DGF is not predictive of poorer graft outcome. Large UK registry data
	DBD 6882	88.0 (5-yr)	83.2 (3-yr)	21.4	2.6	24
Cooper et al[70] 2004 (1984-2000)	DCD 382	Equivalent	65 (5-yr) 45 (10-yr)	27.5	1.05		No difference in PNF
	DBD 1089		71 (5-yr) 48 (10-yr)	21.3	0.83

DCD: Donation after cardiac death; DBD: Donation after brain death; DGF: Delayed graft function; PNF: Primary non function; AR: Acute rejection DCD; Cr: Creatinine.