DACA Kidneys Show Comparable Transplant Outcomes to Non-DACA Donors: Study
Illegal Kidney Transplant
UK: A study has found no evidence that kidneys donated after circulatory arrest (DACA) are associated with worse transplant outcomes, and in some measures, they may even perform slightly better than kidneys from other deceased donors. Researchers caution, however, that these findings should be interpreted in the context of existing organ selection and transplantation practices.
The findings come from a UK population-based cohort study led by Ffion Dewi and colleagues from North Bristol NHS Trust, published in BMC Nephrology. The analysis used national registry data covering all deceased donor kidney transplants performed in the United Kingdom between 2016 and 2020, including 6,239 donors and 11,375 recipients.
Among the donor pool, nearly 44% were classified as DACA donors. These donors showed some baseline differences compared with non-DACA donors, including a higher likelihood of donation after circulatory death and slightly higher terminal creatinine levels. However, they were less frequently categorized as extended criteria donors, indicating differences in donor selection profiles between the two groups.
The study led to the following findings:
- After adjustment for multiple factors, kidneys from DACA donors were linked to a lower risk of delayed graft function after transplantation.
- Recipients of DACA kidneys showed slightly better kidney performance at 12 months, indicated by lower serum creatinine levels compared with non-DACA recipients.
- No significant differences were observed in long-term outcomes between the two groups.
- Patient survival rates were similar in both DACA and non-DACA kidney recipients.
- Graft survival outcomes were also comparable between the two groups.
- DACA donor status did not show any adverse impact on key transplant endpoints during follow-up.
- The findings suggest that concerns about poorer graft quality from DACA donors are not supported by real-world clinical outcomes.
The study also highlights a potential “selection effect,” where current clinical practices in organ acceptance may influence observed results. Because transplant teams may already apply careful selection criteria when using DACA kidneys, the comparable or slightly improved outcomes could reflect optimized donor-recipient matching rather than inherent differences in organ quality.
Despite its strengths, the study is based on observational registry data, which limits causal inference. Differences in clinical decision-making, unmeasured confounders, and donor management practices may have influenced the results. In addition, the findings are specific to UK transplant practices and may not be fully generalizable to other healthcare systems with different organ allocation policies.
Overall, the study provides reassuring evidence that kidneys from donors after circulatory arrest can achieve outcomes comparable to other deceased donor kidneys. The authors suggest that expanding confidence in DACA kidney use could help increase organ availability without compromising transplant success, while emphasizing the importance of continued careful donor evaluation and recipient selection.
Reference:
Dewi, F., Patel, K., Hodson, J. et al. Outcomes of kidney transplants from donors after cardiac arrest; a UK population-based cohort study. BMC Nephrol (2026). https://doi.org/10.1186/s12882-026-04969-z
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