*Purpose: Due to the shortage of organs for transplantation, kidney transplants (KT) from marginal donors including donors with acute kidney injury (AKI) are expanding. Although previous single center experiences comparing the outcomes between AKI and non-AKI donors in KT have shown comparable results, there is limited data on high-volume analysis of KT outcomes with AKI donors.

*Methods: We analyzed SRTR data from 2010-2015. AKI was defined by terminal serum creatinine ≥ 2.0mg/dL. A total 57,009 cases were reviewed (Fig 1) and 5,158 cases (9.05%) were donated from AKI donors. Clinical characteristics of AKI and non-AKI donors were analyzed and outcomes of both groups were compared using graft and patient survivals.

*Results: Mean last serum creatinine levels of non-AKI and AKI donors was 0.94±0.37mg/dL and 3.26±1.92mg/dL, respectively. Demographic between both groups demonstrated greater donor age in non-AKI group and males in the AKI group. Cold ischemic time was longer in AKI group (16.79±8.82 vs 20.56±10.48, P<0.001) Although the incidence of delayed graft function (DGF) was higher in recipients of AKI donors compared to non-AKI donors, the graft and patient survival were not significantly different between non-AKI and AKI groups. (Figure. 2)

*Conclusions: KT from deceased donor with AKI showed comparable outcomes and the use of donors with AKI needs to be considered more actively to expand the donor pool.

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