Transplanting Kidneys from Deceased Donors with Severe Acute Kidney Injury

R. L. Heilman, M. L. Smith, S. M. Kurian, J. Huskey, R. K. Batra, Harini M Chakkera, N. N. Katariya, H. Khamash, A. Moss, D. R. Salomon, Kunam Sudhakar Reddy

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Our aim was to determine outcomes with transplanting kidneys from deceased donors with acute kidney injury, defined as a donor with terminal serum creatinine ≥2.0 mg/dL, or a donor requiring acute renal replacement therapy. We included all patients who received deceased donor kidney transplant from June 2004 to October 2013. There were 162 AKI donor transplant recipients (21% of deceased donor transplants): 139 in the standard criteria donor (SCD) and 23 in the expanded criteria donor (ECD) cohort. 71% of the AKI donors had stage 3 (severe AKI), based on acute kidney injury network (AKIN) staging. Protocol biopsies were done at 1, 4, and 12 months posttransplant. One and four month formalin-fixed paraffin embedded (FFPE) biopsies from 48 patients (24 AKI donors, 24 non-AKI) underwent global gene expression profiling using DNA microarrays (96 arrays). DGF was more common in the AKI group but eGFR, graft survival at 1 year and proportion with IF/TA>2 at 1 year were similar for the two groups. At 1 month, there were 898 differentially expressed genes in the AKI group (p-value <0.005; FDR <10%), but by 4 months there were no differences. Transplanting selected kidneys from deceased donors with AKI is safe and has excellent outcomes.

Original languageEnglish (US)
Pages (from-to)2143-2151
Number of pages9
JournalAmerican Journal of Transplantation
Volume15
Issue number8
DOIs
StatePublished - Aug 1 2015

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Keywords

  • clinical research / practice
  • delayed graft function (DGF)
  • donors and donation: deceased
  • kidney transplantation / nephrology
  • molecular biology: mRNA / mRNA expression

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Heilman, R. L., Smith, M. L., Kurian, S. M., Huskey, J., Batra, R. K., Chakkera, H. M., Katariya, N. N., Khamash, H., Moss, A., Salomon, D. R., & Reddy, K. S. (2015). Transplanting Kidneys from Deceased Donors with Severe Acute Kidney Injury. American Journal of Transplantation, 15(8), 2143-2151. https://doi.org/10.1111/ajt.13260