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Review
. 2024 Jun 1;108(6):1283-1295.
doi: 10.1097/TP.0000000000004848. Epub 2023 Nov 22.

Impact of Deceased-donor Acute Kidney Injury on Kidney Transplantation

Hillary C Yaffe  1   2 , Dagny von Ahrens  1   2 , Alejandra Urioste  3 , Valeria R Mas  3 , Enver Akalin  2   4
Affiliations
Review

Impact of Deceased-donor Acute Kidney Injury on Kidney Transplantation

Hillary C Yaffe et al. Transplantation. .

Abstract

Even as record numbers of deceased donors are undergoing organ recovery, the global transplant community continues to struggle with a shortage of donor organs and a high organ discard rate. Acute kidney injury (AKI) occurs in many hospitalized patients, including up to 25% of patients in critical condition. Registry studies have shown a significant increase in nonrecovery or organ discard rates in AKI donors, despite most studies reporting similar clinical outcomes compared with non-AKI donors. This review aims to capture the salient information learned from these studies and to summarize the efforts that have been made to gain a more granular understanding of how kidneys from donors with AKI behave posttransplant. In particular, we reviewed the studies that analyzed the clinical outcomes in different stages of AKI and AKI in marginal donors, such as kidney donor profile index of >85%, older donors, and donation after circulatory death donors. We summarized studies investigating molecular biomarkers, transcriptomics, and possible future therapeutic targets for postdonation AKI.

Trial registration: ClinicalTrials.gov NCT01848249.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

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    1. Kayler LK, Garzon P, Magliocca J, et al. Outcomes and utilization of kidneys from deceased donors with acute kidney injury. Am J Transplant. 2009;9:367–373.
    1. Mohan S, Chiles MC, Patzer RE, et al. Factors leading to the discard of deceased donor kidneys in the United States. Kidney Int. 2018;94:187–198.

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