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Utilization of High Terminal Creatinine Kidney Donors for Simultaneous Kidney and Pancreas Transplantation

A. Montal, J. Torabi, N. Muhdi, J. Melvin, Y. Miura, M. Ajaimy, L. Lirano, Y. Azzi, C. Pynadath, E. Akalin, S. Greenstein, J. P. Rocca, J. A. Graham

Montefiore Medical Center, Bronx, NY

Meeting: 2020 American Transplant Congress

Abstract number: D-245

Keywords: Donors, marginal, Kidney/pancreas transplantation, Pancreas transplantation

Session Information

Session Name: Poster Session D: Pancreas and Islet: All Topics

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: The use of kidneys with high terminal creatinine has been demonstrated in renal transplantation with excellent outcomes. Here we explore the use of high terminal creatinine donors for simultaneous pancreas-kidney recipients.

*Methods: A retrospective, single center study of 54 simultaneous pancreas-kidney (SPK) recipients who received a kidney from a non-AKI donor (n=32) compared to donors with acute kidney injury (AKI) (n=22). AKI was defined as a terminal creatinine level 1.5x greater than the initial admitting creatinine. Post-operative outcomes included length of Stay (LOS), delayed graft function (DGF), glomerular filtration rate (GFR), Hemoglobin A1c (HbA1c).

*Results: There was no difference in recipient age (39.2 vs 39.4 years, p=0.95) or sex (53 vs 68% male, p=0.27) in the non-AKI and AKI groups. There was no significant difference in donor age (22.7 vs. 23.8 years, p=0.55). During a median 716 days [range: 109-1982] there was one patient death in the non-AKI group. There was no difference in LOS between the non-AKI and AKI groups (9.8 vs. 11.6 days, p=0.46). However, significantly lower rate of DGF occurred in the non-AKI group (9.4 vs. 40.9%, p=0.01). Graft function between two groups was comparable at 1-month (59.3 ml/min vs. 51.3 ml/min; p=0.20), 3-months (62.7 ml/min vs. 69.3 ml/min; p=0.23), 6-months (62.6 ml/min vs. 65.6 ml/min; p=0.56) and 12-months postoperatively (60.0 ml/min vs. 62.8 ml/min; p=0.70). HbA1c was not statistically significant in the non-AKI group compared to AKI group at 3-months (5.3% vs 5.3%; p=0.78), 6-months (5.3% vs. 5.3%, p=0.89) and 12-months (5.6% vs. 5.4%; p=0.43). There was one death in the non-AKI group.

*Conclusions: Kidneys from AKI donors with high terminal creatinine demonstrated comparable outcomes to non-AKI donors.

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To cite this abstract in AMA style:

Montal A, Torabi J, Muhdi N, Melvin J, Miura Y, Ajaimy M, Lirano L, Azzi Y, Pynadath C, Akalin E, Greenstein S, Rocca JP, Graham JA. Utilization of High Terminal Creatinine Kidney Donors for Simultaneous Kidney and Pancreas Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/utilization-of-high-terminal-creatinine-kidney-donors-for-simultaneous-kidney-and-pancreas-transplantation/. Accessed May 10, 2025.

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