Expanding the Donor Pool in Kidney Transplantation: Should Organs with Acute Kidney Injury Be Accepted?-A Retrospective Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Mar 14

PMID 30865677

Citations 8

Authors

Katharina Schutte-Nutgen

Markus Finke

Sabrina Ehlert

Gerold Tholking

Hermann Pavenstadt

Barbara Suwelack

Daniel Palmes

Ralf Bahde

Raphael Koch

Stefan Reuter

Affiliations

Soon will be listed here.

Abstract

Background: Given the gap between patients in need of a renal transplantation (RTx) and organs available, transplantation centers increasingly accept organs of suboptimal quality, e.g. from donors with acute kidney injury (AKI).

Methods: To determine the outcome of kidney transplants from deceased donors with AKI (defined as ≥ AKIN stage 1), all 107 patients who received a RTx from donors with AKI between August 2004 and July 2014 at our center were compared to their respective consecutively transplanted patients receiving kidneys from donors without AKI. 5-year patient and graft survival, frequencies of delayed graft function (DGF), acute rejections and glomerular filtration rate (eGFR, CKD-EPI) were assessed.

Results: Patient survival was similar in both groups, whereas death-censored and overall graft survival were decreased in AKI kidney recipients. AKI kidney recipients showed higher frequencies of DGF and had a reduced eGFR at 7 days, three months and one and three years after RTx. However, mortality was noticeably lower compared to waiting list candidates. Rejection-free survival was similar between groups.

Conclusions: In our cohort, both short-term and long-term renal function was inferior in recipients of AKI kidneys, while patient survival was similar. Our data indicates that recipients of donor AKI kidneys should be carefully selected and additional factors impairing short- and long-term outcome should be minimized to prevent further deterioration of graft function.

Citing Articles

Deceased Kidney Donor Biomarkers: Relationship between Delayed Kidney Function and Graft Function Three Years after Transplantation.

Maslauskiene R, Vaiciuniene R, Tretjakovs P, Gersone G, Radzeviciene A, Bura A Diagnostics (Basel). 2024; 14(7).

PMID: 38611630 PMC: 11011901. DOI: 10.3390/diagnostics14070717.

Impact of acute kidney injury and renal recovery status in deceased donor to kidney transplant outcome: results from the Thai national transplant registry.

Larpparisuth N, Nivatvongs S, Noppakun K, Lumpaopong A, Pongskul C, Skulratanasak P Sci Rep. 2023; 13(1):20492.

PMID: 37993656 PMC: 10665315. DOI: 10.1038/s41598-023-47928-6.

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

Nita G, Gopal J, Khambalia H, Moinuddin Z, van Dellen D Transpl Int. 2023; 36:11232.

PMID: 37275464 PMC: 10233654. DOI: 10.3389/ti.2023.11232.

Excellent clinical outcomes of renal transplant from pediatric deceased donors with acute kidney injury.

Liu Q, Zhang H, Zhong M, Tan L, Hu S, Peng L Eur J Med Res. 2023; 28(1):161.

PMID: 37143170 PMC: 10158327. DOI: 10.1186/s40001-023-01111-9.

Impact of acute kidney injury on graft outcomes of deceased donor kidney transplantation: A nationwide registry-based matched cohort study in Korea.

Ha J, Jung C, Choi S, Kim M, Gwon J, Kim J PLoS One. 2021; 16(11):e0260076.

PMID: 34788335 PMC: 8598029. DOI: 10.1371/journal.pone.0260076.

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