Background
Donation after cardiac death (DCD) is important fraction of kidney transplant programs in many countries. According to literature such kidneys seem to have similar allograft and patient survival compared with kidney from DBD donors; however the main problem is delayed graft function (DGF), which occurs in 40-50% compared with some 20-25% in an standard-criteria donor kidney transplants. Controlled DCD donation and kidney transplantation we introduced in Czech Republic in 2013.

Material and Methods
In 2013 we performed some 282 kidney transplants (KTx) at our institution, of those 10 were from DCD donors. The retrieval with 5 minutes of no-touch interval we performed in 5 cases, 10 kidneys we transplanted. The donor characteristics were as follows: age 39 (SD 13.6), mean Cr min 80,5 umol/l (SD 48,8), or 0,9 mg/dL (SD 0,55), mean Cr max 93,5 umol/l (SD 51), or 1,05 mg/dL (SD 0,58), average cold ischemic time (CIT) was 9.4 hours (SD 5.8).

Results
There was 1 case of delayed graft function (DGF) observed, all the other 9 patients developed prompt kidney graft function. Mean SCr one month after the KTx was 139 umol/l (SD 37), or 1,57 mg/dL (SD 0,42). Mean hospital stay was 13 days (SD 3. 9). The immunosupression protocol was based on TAC/PRED/MMF and induction with Thymoglobulin.

Conclusion
Our initial experience is encouraging as we did not observe any delayed graft function except one case. There is room for expansion of the program in Czech Republic. Short CIT seems to be the key for DGF prevention in our hands.