Transplantation of deceased donor kidneys with Acute Kidney Injury (AKI) has become a generally well accepted practice with excellent results documented in the literature. The majority of patients in these studies had relatively mild degrees of renal impairment as classified by their AKIN (Acute Kidney Injury Network) stage. Even the most advanced AKIN stage (3) can include patients with good urine output and elevated but steady serum creatinine levels. There has not been any guidance on the outcomes of kidneys transplanted from the most severely affected donors- those with no urine output on renal replacement therapy. We report a study of four transplants from such donors performed over the past three months. All kidneys had pre implantation biopsies showing no chronic disease and all kidneys had mixed preservation- initially cold stored then placed on perfusion with acceptable flows and resistance.

Results: Donor characteristics are listed in table 1. Two kidneys came from a donor who took an overdose of sleeping pills, one kidney came from an MVA victim and one from a cardiac arrest causing anoxia.

Recipient outcomes are displayed in table 2.

Two conclusions can be drawn from the short term follow up of these cases. First, successful transplantation can be accomplished from donors with severe AKI. Second, the likelihood of needing post transplant dialysis is very high. We choose patients for AKI kidneys who are not medically complex and are able to tolerate a more complicated post transplant course with dialysis. Two of the recipients had elevated cPRA (84,97) and benefited from receiving a compatible kidney.

CITATION INFORMATION: Bry W, Bellingham J, Katznelson S, Patel P, Ueda K, Mahanty H, Neidlinger N, Hassoun A, Peddi V. Kidney Transplants from Anuric Deceased Donors on Renal Replacement Therapy. Am J Transplant. 2016;16 (suppl 3).

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