ORIGINAL RESEARCH
Transpl. Int.
Cardiopulmonary resuscitation in donation after brain death donors aged ≥65 years: impact on outcomes after kidney transplantation – a multi-center study
- CC
Can Cüneyt Süsal 1
- QB
Quirin Bachmann 2
- FK
Florian Kälble 3
- CF
Christoph Friedrich Mahler 3
- MO
Matthias Ott 4
- JH
Johannes Heymer 4
- MB
Matthias Braunisch 2
- VA
Volker Assfalg 5
- JD
Jürgen Dippon 6
- UH
Uwe Heemann 2
- LR
Lutz Renders 2
- VS
Vedat Schwenger 1
- FE
Fabian Echterdiek 1
1. Department of Nephrology, Katharinenhospital, Stuttgart, Germany
2. Department of Nephrology, Klinikum rechts der Isar der Technischen Universitat Munchen, Munich, Germany
3. Department of Nephrology, UniversitatsKlinikum Heidelberg, Heidelberg, Germany
4. Interdisciplinary Intensive Care Unit, ZIM, Katharinenhospital, Stuttgart, Germany
5. Department of Surgery, Klinikum rechts der Isar der Technischen Universitat Munchen, Munich, Germany
6. Institute for Stochastics and Applications, Universitat Stuttgart, Stuttgart, Germany
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Abstract
A history of cardiopulmonary resuscitation (CPR) is common in donation after brain death (DBD) donors. While good outcomes have been demonstrated for kidney transplantation (KT) from younger CPR donors (aged typically 18–50 years), it is unclear whether this is true for the growing cohort of ≥65-year-old KT donors. To this end, all KTs from ≥65-year-old DBD donors performed at three German transplant centers from January 2006 to December 2023 (n=680) were retrospectively analyzed and outcomes of KTs from donors with and without a history of CPR were compared (n=81 and n=599, respectively). No significant differences were observed regarding the incidence of delayed graft function (DGF) as well as regarding 1-and 5-year graft function between the CPR and no-CPR groups (DGF: 27.2% vs. 33.1%, p=0.40; 1-year eGFR (ml/min): 33.3 vs. 35.0, p=0.75; 5-year eGFR: 35.8 vs. 37.3, p=0.75, respectively). Death-censored graft survival (73.8% vs. 66.0%, p=0.24) and patient survival (78.7% vs. 73.5% p=0.61) were comparable after 5 years between the CPR and no-CPR groups. The results were confirmed by multivariable Cox regression analysis. In conclusion, our results indicate that ≥65-year-old DBD donors with a history of CPR are potentially suitable for KT without impairing allograft outcomes.
Summary
Keywords
cardiopulmonary resuscitation, donation after brain death, Elderly donors, Kidney transplant, Transplant Outcome
Received
09 December 2025
Accepted
07 May 2026
Copyright
© 2026 Süsal, Bachmann, Kälble, Mahler, Ott, Heymer, Braunisch, Assfalg, Dippon, Heemann, Renders, Schwenger and Echterdiek. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Can Cüneyt Süsal, can.suesal@live.de
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