Deceased Donor Kidney Transplantation from Donors with Acute Kidney Injury: Realities and Costs

S. Iskhagi¹, R. Shahbazov¹, A. Ball¹, S. Loerzel¹, E. Shaban², B. Gallay², R. Hod Dvorai³, J. Leggat², M. Hanlon¹, R. Saidi¹

¹Department of Surgery, Division of Transplantation, SUNY Upstate Medical University, Syracuse, NY, ²Department of Medicine, Division of Nephrology, SUNY Upstate Medical University, Syracuse, NY, ³Department of Pathology and Laboratory Medicine, SUNY Upstate Medical University, Syracuse, NY

Meeting: 2022 American Transplant Congress

Abstract number: 737

Keywords: Brain death, Donors, marginal, Kidney transplantation, Procurement

Topic: Clinical Science » Kidney » 32 - Kidney Deceased Donor Selection

Session Information

Session Name: Kidney Deceased Donor Selection

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: The use of kidneys from deceased donors with acute kidney injury (AKI) is one of the options to expand donor pool. Several studied have reported on the transplantation of kidneys with donor AKI with favorable outcomes. The aim of this study was to investigate the outcomes of kidneys transplantation cases where deceased donors developed AKI before organ procurement.

*Methods: We retrospectively reviewed the medical records of recipients from January 2016 to November 2021 in a single center. Outcomes in recipients of a kidney graft from a donor with AKI were compared with outcomes in recipients of a kidney graft from a donor without AKI (non-AKI group). Donor and recipient clinical characteristics with creatinine level, delayed graft function rate, HD requirement after transplant, length of stay, hospital charge, graft and patient survival rate were investigated.

*Results: Total 372 consecutive deceased donors kidney transplantation recipients files were studies. The mean follow up time was 40 months. 92 (24,7%) kidneys were transplanted from AKI donors and 280 (75,3%) from non-AKI donors. Although donor and recipient demographics were similar, donor AKI was associated higher rate DGF 42 patients (45.7%) compare to non-AKI donor where DGF rate was 86 patients (30.7%) (p<0.001). Therefore, patients increased requirements for HD in AKI donor 34 patients (37%) compare to HD after transplant in non-AKI 74 patients (26.4%) (p<0.001). Readmission rates were also higher in AKI group 42.4% versus 35.4% non-AKI group (p<0.001) The hospital charge was comparable in both group (non-AKI 259,220$ and AKI 259267$) due to comparable length of hospital stay 6.5 and 5.8 days (p<0.001).

*Conclusions: Our study shows transplant with donor AKI are associated with increased rate of DGF, HD requirements after transplant and higher incidence of readmission. However, graft and patient survival rates, hospital charge and length of stay were similar in both groups. Our study confirms that grafts from donors with AKI can be used safely and expand donor pool in kidney transplantation without increased cost.

To cite this abstract in AMA style:

Iskhagi S, Shahbazov R, Ball A, Loerzel S, Shaban E, Gallay B, Dvorai RHod, Leggat J, Hanlon M, Saidi R. Deceased Donor Kidney Transplantation from Donors with Acute Kidney Injury: Realities and Costs [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/deceased-donor-kidney-transplantation-from-donors-with-acute-kidney-injury-realities-and-costs/. Accessed May 16, 2025.

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