Successful outcomes with transplanting kidneys from deceased donors with acute kidney injuryon temporary renal replacement therapy

Pooja Budhiraja, Raymond Lackner Heilman, Caroline C. Jadlowiec, Maxwell L. Smith, Margaret S. Ryan, Hasan Ahmad Khamash, Lavanya Kodali, Adyr Moss, Amit K. Mathur, Kunam S. Reddy

Research output: Contribution to journalArticlepeer-review

Abstract

Background and objectives: We aimed to determine outcomes with transplanting kidneys from deceased donors with severe acute kidney injury requiring acute renal replacement therapy (RRT). Materials and methods: A total of 172 recipients received a kidney from donors with acute kidney injury stage 3 (AKIN3) requiring RRT. We compared the study group to 528 recipients who received a kidney from donors with AKIN stage 3 not on RRT and 463 recipients who received < 85% Kidney Donor Profile Index (KDPI) AKIN stage 0 kidney. Results: The study group donors were younger compared to the 2 control groups. Despite higher DGF in the study group, the length of hospital stay and acute rejection were similar. Death censored graft survival (96% AKIN3-RRT vs. 97%AKIN3 no RRT vs. 96% KDPI < 85% AKIN0, P = 0.26) and patient survival with functioning graft at 1 year (95% across all groups, P = 0.402) were similar. The estimated glomerular filtration rate were similar across the 3 groups after first month. Interstitial fibrosis and tubular atrophy score ≥ 2 on protocol biopsy at time 0, 4 and 12 months were similar. Primary nonfunction was rare and associated with high KDPI. Conclusions: Transplanting selected kidneys from deceased donors with AKIN3 requiring RRT is safe and has good outcomes.

Original languageEnglish (US)
JournalClinical Transplantation
DOIs
StateAccepted/In press - 2021

Keywords

  • acute kidney injury
  • deceased donor
  • graft survival
  • kidney transplant
  • organ procurement
  • renal replacement therapy

ASJC Scopus subject areas

  • Transplantation

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