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Meta-Analysis
. 2023 May 18:36:11232.
doi: 10.3389/ti.2023.11232. eCollection 2023.

Kidney Transplantation From Donors With Acute Kidney Injury: Are the Concerns Justified? A Systematic Review and Meta-Analysis

George Emilian Nita  1 , Jeevan Prakash Gopal  1 , Hussein A Khambalia  1   2 , Zia Moinuddin  1   2 , David van Dellen  1   2
Affiliations
Meta-Analysis

Kidney Transplantation From Donors With Acute Kidney Injury: Are the Concerns Justified? A Systematic Review and Meta-Analysis

George Emilian Nita et al. Transpl Int. .

Abstract

Renal transplantation improves quality of life and prolongs survival in patients with end-stage kidney disease, although challenges exist due to the paucity of suitable donor organs. This has been addressed by expanding the donor pool to include AKI kidneys. We aimed to establish whether transplanting such kidneys had a detrimental effect on graft outcome. The primary aim was to define early outcomes: delayed graft function (DGF) and primary non-function (PNF). The secondary aims were to define the relationship to acute rejection, allograft survival, eGFR and length of hospital stay (LOS). A systematic literature review and meta-analysis was conducted on the studies reporting the above outcomes from PubMed, Embase, and Cochrane Library databases. This analysis included 30 studies. There is a higher risk of DGF in the AKI group (OR = 2.20, p < 0.00001). There is no difference in the risk for PNF (OR 0.99, p = 0.98), acute rejection (OR 1.29, p = 0.08), eGFR decline (p = 0.05) and prolonged LOS (p = 0.11). The odds of allograft survival are similar (OR 0.95, p = 0.54). Transplanting kidneys from donors with AKI can lead to satisfactory outcomes. This is an underutilised resource which can address organ demand.

Keywords: acute kidney injury; delayed graft function; donors and donation; graft outcome; primary non-function.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart.
FIGURE 2
FIGURE 2
Delayed graft function—Forrest plot.
FIGURE 3
FIGURE 3
Primary non-function—Forrest plot.
FIGURE 4
FIGURE 4
Acute rejection—Forrest plot.
FIGURE 5
FIGURE 5
Allograft survival–Forrest plot.
FIGURE 6
FIGURE 6
eGFR—Forrest plot.
FIGURE 7
FIGURE 7
Length of hospital stay—Forrest plot.
See this image and copyright information in PMC

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