Excellent Long-Term Outcomes with Kidney Transplants from Deceased Donors with Acute Kidney Injury
Medicine, Columbia University Medical Center, New York, NY.
Meeting: 2018 American Transplant Congress
Abstract number: C55
Keywords: Graft survival, 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
Kidney transplants (KT) from donors with acute kidney injury (AKI; terminal creatinine ≥ 2.0) are increasingly performed and have similar short-term outcomes compared with KT from donors without AKI. There are limited data on long-term outcomes of KT with AKI kidneys.
Methods: We reviewed all KT at our center from 2005-2009. Patients who received a KT from a donor with AKI were compared with KT recipients of kidneys with a terminal creatinine < 1.5. All patients received induction therapy and underwent early steroid withdrawal. Maintenance regimens were the same in the AKI and non-AKI groups (tacrolimus + MMF). We compared long-term renal function, patient and graft survival between the AKI and non-AKI groups. Patients were followed until death, graft failure, or 10/31/17.
Results: Recipient and transplant characteristics are shown in table.
| No AKI (n=374) | AKI (n=157) | p | |
| Age | 54 ± 13.1 | 52.8 ± 13.7 | ns |
| Female | 41% | 36% | ns |
| White | 42% | 38% | ns |
| Black | 24% | 27% | ns |
| Diabetes | 32% | 36% | ns |
| Retransplant | 20% | 13% | ns |
| Preemptive | 14% | 17% | ns |
| Donor age | 39.2 ± 21.3 | 39.2 ± 13.9 | ns |
| Terminal creatinine | 0.83 ± 0.33 | 3.16 ± 1.15 | <0.01 |
| Cold ischemia | 30.7 ± 10.6 | 32.4 ± 9.8 | ns |
| Thymoglobulin | 82% | 82% | ns |
| DGF | 38% | 57% | <0.01 |
| Creatinine 3-years | 1.68 ± 1 | 1.62 ±0.74 | ns |
| Creatinine 5-years | 1.67 ± 0.9 | 1.71± 0.83 | ns |
| Creatinine 7-years | 1.49 ± 0.69 | 1.73 ± 0.9 | p=0.02 |
Mean follow up was 6.6 years in both groups. There was no difference in patient survival or death-censored graft survival.
Conclusions: KT from donors with AKI provide similar excellent long-term patient and allograft survival compared with KT from donors without AKI. Long-term renal function, as measured by creatinine, was good in both groups, though AKI kidneys did have higher creatinine by 7 years. Increased use of AKI kidneys is a safe way to address the organ shortage.
CITATION INFORMATION: Dube G., Husain S., Cohen D., Mohan S. Excellent Long-Term Outcomes with Kidney Transplants from Deceased Donors with Acute Kidney Injury Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Dube G, Husain S, Cohen D, Mohan S. Excellent Long-Term Outcomes with Kidney Transplants from Deceased Donors with Acute Kidney Injury [abstract]. https://atcmeetingabstracts.com/abstract/excellent-long-term-outcomes-with-kidney-transplants-from-deceased-donors-with-acute-kidney-injury/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress