Early Outcomes of the New UK Deceased Donor Kidney Fast-track Offering Scheme.

Background: The UK Kidney Fast-Track Scheme (KFTS) was introduced in 2012 to identify kidneys at high risk of discard and to rapidly facilitate transplantation. A retrospective analysis of kidneys transplanted through the KFTS was undertaken. Methods: UK Transplant Registry data were collected on deceased donor kidneys implanted between 1 November 2012 and 30 April 2015 (DBD donors) and 1 March 2013 and 30 April 2015 (DCD donors). Posttransplant outcomes included 1-year eGFR and death-censored graft survival (DCGS). Results: Over the study period, 523 deceased donor kidneys were transplanted through the KFTS and 4,174 via the standard National Kidney Allocation Scheme (NKAS). Kidneys in the KFTS were more likely to be from older, diabetic donors, had a higher frequency of poor ex vivo perfusion, longer cold ischaemic times and were transplanted into older recipients. One-year DCGS of KFTS and NKAS DBD donor kidneys was similar (94% versus 95%; p=0.70), but for DCD donor kidneys DCGS was lower in those allocated via the KFTS (91% versus 95%; p=0.04). Median 1-year eGFR for DBD donor kidneys was lower in those allocated via the KFTS (49 versus 52 mL/min/1.73m2; p=0.01), but for DCD kidneys there was no difference (45 versus 48 mL/min/1.73m2; p=0.10). Conclusions: Although KFTS kidneys have less favourable donor, graft, and recipient risk factors than NKAS kidneys, short-term graft and patient outcomes are acceptable. National schemes that identify and rapidly offer kidneys at high risk of discard may contribute to minimising the unnecessary discard of organs. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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