Chapter 22 Transplant - donors

22.1 Donor types

Generally good outcomes have been observed for living unrelated donors and DCD donors:

Terasaki et al. (1995): - outcomes in living unrelated transplants.

Snoeijs et al. (2010): - survival benefit of DCD kidney.

Summers et al. (2010): - UK transplant registry data showed 5-yr outcomes from DCD donors equivalent to DBD donors.

22.2 Donor AKI

In deceased donors, donor AKI is associated with non-inferior outcomes in some cohorts. Severe donor AKI (AKIN 3) is associated with worse graft function at 1 yr and increased rates of primary non-function. Mild donor AKI (AKIN 1 and 2) is associated with generally good long-term graft function:

Boffa et al. (2017): - UK registry data.

Hall et al. (2019): - US cohorts.

22.3 Ischaemic time

Observational studies have examined the effects of cold and warm ischaemic time on patient and graft outcomes:

Debout et al. (2015): - longer cold-ischaemic time was associated with worse graft survival and higher mortality in recipients of DBD kidneys (French cohort).

Gill et al. (2017): - CIT of up to 16 hrs was not associated with graft loss in recipients of kidneys from living donors (large Canadian cohort).