Clinical Outcomes in Kidney Transplantation from Deceased Donors with Acute Kidney Injury Based on Acute Kidney Injury Network Criteria

J. G. Gwon, Myung-Gyu Kim, K. T. Park, Sun-Young Ko, Cheol Woong Jung

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Abstract

Introduction: Kidneys from acute kidney injury (AKI) donors are used for kidney transplantation. However, different Acute Kidney Injury Network (AKIN) criteria may show varying results after transplantation. We investigated the clinical outcomes in kidney transplantation from deceased donors with AKI as defined by the AKIN criteria at a single center. Methods: We retrospectively reviewed the medical records of 101 consecutive deceased donors and kidney transplantation recipients from March 2009 to June 2015 in a single center. Donor and recipient clinical characteristics with creatinine level, delayed graft function, estimated glomerular filtration rate (eGFR), rejection, and graft survival were investigated. Results: Of the 101 deceased donor kidneys, AKI occurred in 64 (63.4%) deceased donors. No differences in eGFR and serum creatinine level were found according to AKIN criteria. However, the AKIN stage 3 group had a slightly decreased kidney function without statistical significance. In the older AKI donor group, creatinine level was significantly higher than in other groups at 1 month (P =.015). No differences were found between the 2 groups in patient survival, graft survival, or rejection-free survival (P =.359, P =.568, and P =.717, respectively). Conclusions: Kidney transplantation from deceased donors with AKI showed comparable outcomes despite high rates of delayed graft function. AKIN stage 3 donors and aged-deceased donors with AKI showed a slightly reduced renal function without statistical significance; hence, use from donors with AKI needs to be considered to expand donor pools, but caution should be taken for AKIN stage 3 donors and aged donors with AKI.

Original languageEnglish
Pages (from-to)2426-2430
Number of pages5
JournalTransplantation Proceedings
Volume50
Issue number8
DOIs
Publication statusPublished - 2018 Oct 1

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Acute Kidney Injury
Kidney Transplantation
Tissue Donors
Delayed Graft Function
Kidney
Creatinine
Graft Survival
Glomerular Filtration Rate
Survival
Graft Rejection
Medical Records
Transplantation

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

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title = "Clinical Outcomes in Kidney Transplantation from Deceased Donors with Acute Kidney Injury Based on Acute Kidney Injury Network Criteria",
abstract = "Introduction: Kidneys from acute kidney injury (AKI) donors are used for kidney transplantation. However, different Acute Kidney Injury Network (AKIN) criteria may show varying results after transplantation. We investigated the clinical outcomes in kidney transplantation from deceased donors with AKI as defined by the AKIN criteria at a single center. Methods: We retrospectively reviewed the medical records of 101 consecutive deceased donors and kidney transplantation recipients from March 2009 to June 2015 in a single center. Donor and recipient clinical characteristics with creatinine level, delayed graft function, estimated glomerular filtration rate (eGFR), rejection, and graft survival were investigated. Results: Of the 101 deceased donor kidneys, AKI occurred in 64 (63.4{\%}) deceased donors. No differences in eGFR and serum creatinine level were found according to AKIN criteria. However, the AKIN stage 3 group had a slightly decreased kidney function without statistical significance. In the older AKI donor group, creatinine level was significantly higher than in other groups at 1 month (P =.015). No differences were found between the 2 groups in patient survival, graft survival, or rejection-free survival (P =.359, P =.568, and P =.717, respectively). Conclusions: Kidney transplantation from deceased donors with AKI showed comparable outcomes despite high rates of delayed graft function. AKIN stage 3 donors and aged-deceased donors with AKI showed a slightly reduced renal function without statistical significance; hence, use from donors with AKI needs to be considered to expand donor pools, but caution should be taken for AKIN stage 3 donors and aged donors with AKI.",
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T1 - Clinical Outcomes in Kidney Transplantation from Deceased Donors with Acute Kidney Injury Based on Acute Kidney Injury Network Criteria

AU - Gwon, J. G.

AU - Kim, Myung-Gyu

AU - Park, K. T.

AU - Ko, Sun-Young

AU - Jung, Cheol Woong

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N2 - Introduction: Kidneys from acute kidney injury (AKI) donors are used for kidney transplantation. However, different Acute Kidney Injury Network (AKIN) criteria may show varying results after transplantation. We investigated the clinical outcomes in kidney transplantation from deceased donors with AKI as defined by the AKIN criteria at a single center. Methods: We retrospectively reviewed the medical records of 101 consecutive deceased donors and kidney transplantation recipients from March 2009 to June 2015 in a single center. Donor and recipient clinical characteristics with creatinine level, delayed graft function, estimated glomerular filtration rate (eGFR), rejection, and graft survival were investigated. Results: Of the 101 deceased donor kidneys, AKI occurred in 64 (63.4%) deceased donors. No differences in eGFR and serum creatinine level were found according to AKIN criteria. However, the AKIN stage 3 group had a slightly decreased kidney function without statistical significance. In the older AKI donor group, creatinine level was significantly higher than in other groups at 1 month (P =.015). No differences were found between the 2 groups in patient survival, graft survival, or rejection-free survival (P =.359, P =.568, and P =.717, respectively). Conclusions: Kidney transplantation from deceased donors with AKI showed comparable outcomes despite high rates of delayed graft function. AKIN stage 3 donors and aged-deceased donors with AKI showed a slightly reduced renal function without statistical significance; hence, use from donors with AKI needs to be considered to expand donor pools, but caution should be taken for AKIN stage 3 donors and aged donors with AKI.

AB - Introduction: Kidneys from acute kidney injury (AKI) donors are used for kidney transplantation. However, different Acute Kidney Injury Network (AKIN) criteria may show varying results after transplantation. We investigated the clinical outcomes in kidney transplantation from deceased donors with AKI as defined by the AKIN criteria at a single center. Methods: We retrospectively reviewed the medical records of 101 consecutive deceased donors and kidney transplantation recipients from March 2009 to June 2015 in a single center. Donor and recipient clinical characteristics with creatinine level, delayed graft function, estimated glomerular filtration rate (eGFR), rejection, and graft survival were investigated. Results: Of the 101 deceased donor kidneys, AKI occurred in 64 (63.4%) deceased donors. No differences in eGFR and serum creatinine level were found according to AKIN criteria. However, the AKIN stage 3 group had a slightly decreased kidney function without statistical significance. In the older AKI donor group, creatinine level was significantly higher than in other groups at 1 month (P =.015). No differences were found between the 2 groups in patient survival, graft survival, or rejection-free survival (P =.359, P =.568, and P =.717, respectively). Conclusions: Kidney transplantation from deceased donors with AKI showed comparable outcomes despite high rates of delayed graft function. AKIN stage 3 donors and aged-deceased donors with AKI showed a slightly reduced renal function without statistical significance; hence, use from donors with AKI needs to be considered to expand donor pools, but caution should be taken for AKIN stage 3 donors and aged donors with AKI.

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