Kidney Transplantation: Local Donor and Distant Recipient, Is It Feasible? A Retrospective Cross-Sectional Study

Background: Delayed graft function (DGF) and slow graft function (SGF) are complications after kidney transplantation that resulted in poor short-term outcome. Objectives: In this study, we evaluate a new model for deceased kidney transplantation to reduce the cold ischemia time and its effect on DGF and SGF as short-term outcomes. Methods: We have included 814 deceased kidney transplanted patients in this study. All of the donors were local, while the recipients were both local and nonlocal. Kidney recipient’s outcomes (included mortality rate as well as DGF and SGF), age, gender, BMI, blood group, Rh, allograft renal function, transplantation date, kidney transplantation history, PPD, positive history of rheumatologic disorders, the distance between home of recipient and the transplantation center, cardiovascular disease, and dialysis duration was evaluated for all patients. Results: The incidence of DGF and SGF were 24.8% and 20.5%, respectively. There were no statistical differences in the rate of DGF and SGF between local and distant recipients (P > 0.21). The rate of DGF was significantly higher in females as well as 40 - 65 year old recipients (P < 0.05). In logistic regression multivariate analysis, DGF and SGF were significantly correlated with BMI, blood group, the history of kidney transplantation, and dialysis duration. Conclusions: This study showed the feasibility of using a local donor for a distant recipient as well as reduction of cold ischemia time and lower rate of DGF. It is obvious that the shorter CIT, which resulted from usage of local donor, can lead to better kidney transplant outcomes.