Long‐term outcomes of kidney transplantation from deceased donors with terminal acute kidney injury: Single center experience and literature review. Issue 3 (28th December 2022)

• Record Type: Journal Article
• Authors: Garner, Matthew; Jay, Colleen L.; Sharda, Berjesh; Webb, Christopher; Farney, Alan C.; Orlando, Giuseppe; Rogers, Jeffrey; Reeves‐Daniel, Amber; Mena‐Gutierrez, Alejandra; Sakhovskaya, Natalia; Stratta, Bobby; Stratta, Robert J.
• Is Part Of: Clinical transplantation. Volume 37:Issue 3(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-12-28
• Subjects: acute kidney injury -- deceased donor -- delayed graft function -- outcomes -- standard criteria donors; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.14886
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Introduction: Long‐term outcomes of kidney transplantation from deceased donors (DDKTs) with terminal acute kidney injury (AKI) are not well defined. Methods: Single center retrospective review of DDKTs from 1/31/07‐12/31/19. AKI kidneys were defined by a doubling of the donor's admission serum creatinine (SCr) level AND a terminal SCr ≥2.0 mg/dl. Results: A total of 188 AKI DDKTs were performed, including 154 from brain‐dead standard criteria donors (SCD). Mean donor age was 36 years and mean Kidney Donor Profile Index was 50%; mean admission and terminal SCr levels were 1.3 and 3.1 mg/dl, respectively. With a mean follow‐up of 94 months (median 89 months), overall patient (both 71.3%) and graft survival (54% AKI vs. 57% non‐AKI) rates were comparable to concurrent DDKTs from brain‐dead non‐AKI SCDs ( n = 769). Delayed graft function (DGF) was higher in AKI kidney recipients (47% vs. 20% non‐AKI DDKTs, p < .0001). DGF was associated with lower graft survival in recipients of both AKI and non‐AKI SCD kidneys but the impact was earlier and more pronounced in non‐AKI recipients. Conclusions: Despite having more than twice the incidence of DGF, kidneys from deceased donors with terminal AKI have long‐term outcomes comparable to non‐AKI SCD kidneys and represent a safe and effective method to expand the donor pool.