Risk Stratification for Optimized Utilization of Deceased Donor Kidneys with Acute Kidney Injury by KDIGO Criteria.
1Internal Medicine, Seoul National University Hospital, Seoul, Korea
2Transplantation Center, Seoul National University Hospital, Seoul, Korea
3Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
4General Surgery, Seoul National University Hospital, Seoul, Korea.
Meeting: 2016 American Transplant Congress
Abstract number: C182
Keywords: Graft failure, Graft function, Graft survival
Session Information
Session Name: Poster Session C: Kidney Transplantation: AKI/Preservation/DCD
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background
Deceased donor kidneys with acute kidney injury (AKI) raise fear of poor graft outcomes to the transplant clinicians and consequently are often discarded. However, the growing evidence has suggested that they may be a good solution to overcome disparity between organ supply and demand for kidney transplants. Although previous studies have focused on fair outcome of donor AKI, there is limited data regarding the factors affecting graft outcomes in patients received deceased donor kidneys with AKI.
Methods
We analyzed the factors affecting outcomes including delayed graft function (DGF), 6 month, 1-, 3-, 5-year graft function, and 5-year survival of patients who received deceased donor kidneys with AKI.
Results
Among a total of 245 patients, 63 received kidneys from donors with AKI (AKI group) including 42 stage 1, 11 stage 2, and 10 stage 3. Severe donor AKI with terminal serum creatinine more than 2.0 mg/dL was 29 (46%). Other 182 were received kidneys from donors without AKI (no AKI group). Demographic factors of both donors and recipients were not affected by donor AKI. Donor AKI was associated with more use of dobutamine and lower urine output. In the outcome measurement, DGF significantly increased in AKI group compared with no AKI group with adjusted relative risks of 2.67 (1.15-6.25). Graft functions measured by serum creatinine after 6 month, 1-, 3-, 5-year after transplantation were not different in AKI and no AKI group, as well as donor AKI severity or changes. Moreover, 5-year graft and recipient survival were not statistically different in two groups. The risk of DGF development also increased in recipients with diabetes than those without (adjusted OR (95% CI), 3.28 (1.38-7.83)). In DM recipients, donor AKI and worsening pattern of donor creatinine level just before transplantation increased risk for DGF (adjusted OR, 4.67 (1.16-18.82); 1.41 (1.15-1.72), respectively. In recipients without DM, these factors did not increase risk for DGF.
Conclusions
We demonstrated that deceased donor AKI is morbid but reversible in allograft and recipients outcomes. However, clinicians should pay more attention to the risk of DGF in diabetic recipient and worsening AKI.
CITATION INFORMATION: Yu B, Koo T, Lee J, Yang J, Ha J, Ahn C, Kim Y, Lee H. Risk Stratification for Optimized Utilization of Deceased Donor Kidneys with Acute Kidney Injury by KDIGO Criteria. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Yu B, Koo T, Lee J, Yang J, Ha J, Ahn C, Kim Y, Lee H. Risk Stratification for Optimized Utilization of Deceased Donor Kidneys with Acute Kidney Injury by KDIGO Criteria. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/risk-stratification-for-optimized-utilization-of-deceased-donor-kidneys-with-acute-kidney-injury-by-kdigo-criteria/. Accessed June 7, 2025.« Back to 2016 American Transplant Congress