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Review
. 2023 Mar;37(3):e14886.
doi: 10.1111/ctr.14886. Epub 2022 Dec 28.

Long-term outcomes of kidney transplantation from deceased donors with terminal acute kidney injury: Single center experience and literature review

Matthew Garner  1 , Colleen L Jay  1 , Berjesh Sharda  1 , Christopher Webb  1 , Alan C Farney  1 , Giuseppe Orlando  1 , Jeffrey Rogers  1 , Amber Reeves-Daniel  2 , Alejandra Mena-Gutierrez  2 , Natalia Sakhovskaya  2 , Bobby Stratta  1 , Robert J Stratta  1
Affiliations
Review

Long-term outcomes of kidney transplantation from deceased donors with terminal acute kidney injury: Single center experience and literature review

Matthew Garner et al. Clin Transplant. 2023 Mar.

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.

Keywords: acute kidney injury; deceased donor; delayed graft function; outcomes; standard criteria donors.

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References

REFERENCES

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