부산대학교 도서관

【Objective】Donation after cardiac death (DCD) is internationally considered to be an encouraging source of organs for transplantation and has a potential to increase the number of organ donors. The purpose of this study is to clarify the current state of deceased kidney transplantations in Kanagawa Prefecture, Japan, and to assess the availability of DCD donors.【Methods】From July 2010 to October 2013, thirty-six kidney transplantations from 24 deceased donors were performed in Kanagawa Prefecture. We retrospectively reviewed the clinical records of these donors and their recipients and compared the outcomes of deceased donor kidney transplantations between DCD and donation after brain death (DBD).【Results】Comparisons of the donors between 12 DCD and 12 DBD revealed that the DBD donor group was younger (P＜0.01) and had a higher percentage of females (P=0.04). Also, the DCD donor group had longer warm ischemia times (P＜0.01) and longer durations of anuria before donation (P＜0.01). Significant differences were not found in other donor factors (cause of death, serum creatinine on the day of admission, history of hypertension, history of diabetes mellitus, and history of cardiac arrest before donation). In the recipients of deceased kidney transplants (21 from DCD and 15 from DBD), the DCD group had longer cold ischemia time (P＜0.01) and longer total ischemia time (P＜0.01), higher delayed graft function rate (P＜0.01), and longer duration requiring hemodialysis after transplantation (P=0.03). No significant differences were observed in serum creatinine levels (P=0.12) and other recipient factors (age, sex ratio, waiting period, and HLA mismatch) between the two groups. At a mean follow-up time of 376±260 days, 34 recipients were alive with functioning grafts; one DCD recipient was alive with primary graft nonfunction, and one DBD recipient had died with a functioning graft.【Conclusions】Although based on a limited number of cases with short follow-up periods, our study suggests that the outcomes of kidney transplantation from DCD donors are comparable with those from DBD donors, and DCD transplantation has the potential to expand the donor pool.