Kidney Transplantation (KTx) Using Kidneys from Deceased Donors (DD) with Severe AKI Does Not Negatively Impact 1 Year Biopsy Chronic Changes
Mayo Clinic, Phoenix.
Meeting: 2018 American Transplant Congress
Abstract number: C54
Keywords: Biopsy, Kidney transplantation
Session Information
Session Name: Poster Session C: Kidney Donor Selection / Management Issues
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background
Despite the persistent donor shortage, donor kidneys with an acute kidney injury are declined. The aim of this study to determine the difference in biopsy findings of AKI kidneys at 1 year post transplant.
Methods
We included KTx from DD at our center between 2008 and 9/2017. We discard kidneys with 10% cortical necrosis or more than mild chronic changes on pre-implantation biopsy. We extracted data from DonorNet in order to classify the severity of AKI using the AKIN staging system (stage 0-3). The primary outcome is difference in biopsy findings at 1 year post transplant in different AKIN stages.
Results
We were able to determine the AKIN stage in 1193 (83.7%) of the DD KTx during this period. 593 (49.7%) were AKIN stage 2-3. The AKIN 2-3 group was more likely diabetic and on dialysis pre KTx. AKIN 2-3 group donors were younger, more likely male and black race and had lower KDPI. Reperfusion biopsies (RBx) were available in 65.8% of the AKIN 2-3 group and 62.3% in the AKIN 0-1 group.The chronic changes were not higher on the 1 year biopsy in the AKIN 2-3 group.(e.g., %ci> 0 17.3 vs. 34.2, p=0.02).
| Chronic Banff Score | AKIN2-3 (n=365) | AKIN 0-1(n=345) | P |
| % glomerular sclerosis | 4.58(8.20) | 6.37( 10. | 0.03 |
| ci** | 1.04(0.04) | 1.09(0.04) | 0.42 |
| %ci>1 | 21.4 | 25.1 | 0.24 |
| ct** | 1.11(0.04) | 0.11( 0.04) | 0.97 |
| cv** | 0.51(0.03) | 0.56( 0.04) | 0.34 |
**mean (SEM)
Conclusions –
KTx from DD with AKIN stage 2-3 is not associated with more chronic changes on 1 year protocol biopsy. Carefully selected kidneys from DD with severe AKI are a good option for patients listed for kidney transplantation.
CITATION INFORMATION: Kumar A., Srinivasan A., Mathur A., Huskey J., Khamash H., Smith M., Moss A., Reddy K., Heilman R. Kidney Transplantation (KTx) Using Kidneys from Deceased Donors (DD) with Severe AKI Does Not Negatively Impact 1 Year Biopsy Chronic Changes Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kumar A, Srinivasan A, Mathur A, Huskey J, Khamash H, Smith M, Moss A, Reddy K, Heilman R. Kidney Transplantation (KTx) Using Kidneys from Deceased Donors (DD) with Severe AKI Does Not Negatively Impact 1 Year Biopsy Chronic Changes [abstract]. https://atcmeetingabstracts.com/abstract/kidney-transplantation-ktx-using-kidneys-from-deceased-donors-dd-with-severe-aki-does-not-negatively-impact-1-year-biopsy-chronic-changes/. Accessed November 24, 2024.« Back to 2018 American Transplant Congress