Excellent Outcomes with Transplantation of Kidneys (KTx) from Deceased Donors (DDs) with Acute Kidney Injury (AKI)
Division of Transplantation, Dept of Surgery, University of California Davis Medical Center, Sacramento, CA
Meeting: 2013 American Transplant Congress
Abstract number: 538
Background:
AKI is common among DDs and results in high discard rates. In contrast, we have consistently used kidneys from DDs with AKI. We studied our recipients of AKI vs. non-AKI grafts to determine whether concerns regarding inferior outcomes of AKI grafts are justified.
Methods:
We reviewed all adult DD single-kidney KTxs performed at our center 01/2005-06/2012. Donor AKI was defined as terminal creatinine >2.0.
Results:
We identified 703 KTxs (AKI, n=83 [12%]; non-AKI, n=620 [88%, control group]). AKI (vs. non-AKI) donor kidneys had longer CIT, were more frequently imported (table-1), had higher DGF rates (table-2), but yielded similar graft and patient survival [Figure 1] [Figure 2]. e-GFR was similar; 62.8 (AKI) vs 63.2 ml/min at 3 years, p=0.9.
| AKI (n=83) | Non-AKI (n=620) | p value | |
| Age of Recipient | 57 ±13.6 | 54 ±12.8 | 0.024 |
| Age of Donor | 42 ±14.4 | 40 ±16.4 | 0.18 |
| Cold ischemic time (hrs) | 23.6 ±7.46 | 19.8 ±9.81 | <0.001 |
| Imported graft (%) | 76 | 38 | <0.001 |
| ECD (%) | 26.5 | 18.4 | 0.08 |
| Donor terminal Cr (mg/dl) | 3.2 ±1.37 | 0.98 ±0.39 | <0.001 |
| Donor e-GFR (mg/min) | 26 ±9.3 | 105 ±79.3 | <0.001 |
| AKI (n=83) | Non-AKI (n=620) | p value | |
| Delayed graft Function | 30 (36%) | 124 (20%) | 0.001 |
| Graft Failure within 90 days | 2 (2.4%) | 28 (4.5%) | 0.6 |
| Acute Rejection within 1st year | 3 (3.6%) | 33 (5.3%) | 0.79 |
Conclusion:
In spite of a mean terminal donor creatinine of 3.2 mg/dl and less favorable preservation characteristics, AKI (as compared to non-AKI) grafts yielded similar short- and longer-term outcomes. Our results suggest that the high discard rates for donor kidneys with AKI are unwarranted. Further research is warranted to determine factors which should preclude utilization of kidneys from specific donors with AKI.
To cite this abstract in AMA style:
Santhanakrishnan C, Mattos ADe, McVicar J, Perez R, Troppmann C. Excellent Outcomes with Transplantation of Kidneys (KTx) from Deceased Donors (DDs) with Acute Kidney Injury (AKI) [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/excellent-outcomes-with-transplantation-of-kidneys-ktx-from-deceased-donors-dds-with-acute-kidney-injury-aki/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress