Donation after cardiac death: the University of Wisconsin experience.
OBJECTIVE
The objective of this analysis was to compare the results of transplantation of livers, pancreases, kidneys, and lungs from donation after cardiac death (DCD) donors to organs transplanted from donation after brain death (DBD) donors.


METHODS
From January 1984 through July 2000, outcomes of 382 DCD kidneys were compared to 1,089 kidneys (SPK) transplants and 36 liver transplants from DCD donors were compared to 455 SPK and 510 liver transplants from DBD donors. Likewise, 31 simultaneous pancreas-kidneys transplants from DBD donors.


RESULTS
The rate of delayed graft function (DGF) was higher in kidneys transplanted from DCD donors (27.5% versus 21.3%, p=0.01). Likewise, discharge creatinines were higher in recipients of DCD kidneys (1.9 mg/dL versus 1.7 mg/dL, p=0.001). There was no difference in 10-year graft survival between DCD and DBD recipients (45.0% versus 48.0%, p=0.054). No difference in 5-year pancreatic and renal allograft survival was seen after SPK from DCD or DBD donors. After liver transplantation, biliary strictures were higher in recipients of DCD livers (13.9% versus 8.0%, p=0.03). Likewise, 3-year patient and graft survivals were lower for recipients of DCD livers (65.8% versus 84.9%, p=0.01; and 58.6% versus 76.9%, p=0.006).


CONCLUSIONS
This large experience with transplantation from DCD donors demonstrates that similar patient and graft survivals can be expected when compared to recipients of organs from DBD donors.
D'Alessandro
Anthony M
AM
Department of Surgery, University of Wisconsin Medical School, USA. tony@surgery.wisc.edu
Fernandez
Luis A
LA
Chin
L Thomas
LT
Shames
Brian D
BD
Turgeon
Nicole A
NA
Scott
David L
DL
Di Carlo
Antonio
A
Becker
Yolanda T
YT
Odorico
Jon S
JS
Knechtle
Stuart J
SJ
Love
Robert B
RB
Pirsch
John D
JD
Becker
Bryan N
BN
Musat
Alexandru I
AI
Kalayoglu
Munci
M
Sollinger
Hans W
HW
D001926:Brain Death; D003643:Death; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016040:Lung Transplantation; D016377:Organ Transplantation / Q000592:standards*; D016035:Pancreas Transplantation; D016019:Survival Analysis; D014019:Tissue Donors