Clinical outcome of kidney transplantation from deceased donors with acute kidney injury by Acute Kidney Injury Network criteria

Lee, Myung Hyun; Jeong, Eun-Gyo; Chang, Ji Yeun; Kim, Yaeni; Kim, Ji-Il; Moon, In Sung; Choi, Bum Soon; Park, Cheol Whee; Yang, Chul Woo; Kim, Yong‐Soo; Chung, Byung Ha

doi:10.1016/j.jcrc.2013.12.016

Cited by 38 publications

(56 citation statements)

References 24 publications

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“…Mean serum creatinine concentration was 2.41 ± 0.88 mg/dL at time of procurement and 1.06 ± 0.32 mg/dL on admission in AKI donors, and 0.81 ± 0.26 mg/dL in controls (Table 1). AKI donors had a lower 24-h urine production (3.22 ± 1.95 vs. 4.59 ± 2.53 L, p = 0.009), were more frequently exposed [13][14][15][16][17][18][19][20][21][22][23] days in controls, p = 0.05) ( Table 3). While significant elevations in serum creatinine were noted in these patients until 10 days after transplantation, this difference lost statistical significance by day 14 (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…However, in the last 10 years, case reports and large case series have been published and clinical practice has been changing, i.e., AKI kidneys from wellselected DBDs can successfully be used for transplantation [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Specifically, two recent large studies deserve to be highlighted.…”

Section: Introductionmentioning

confidence: 99%

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Excellent graft and patient survival after renal transplantation from donors after brain death with acute kidney injury: a case–control study

et al. 2015

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Excellent graft and patient survival after renal transplantation from donors after brain death with acute kidney injury: a case–control study

et al. 2015

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“…However, there was no difference between the pediatric AKI and non‐AKI groups. Several studies have observed that organs from donors with AKI are associated with a higher incidence of DGF, but all these studies focused on adult donors. Si Nga et al explored the relationship between DGF and donor age (mean age >50 years) among adult donors with AKI and found that one additional year of donor age increased the risk of DGF by 1.08 times ( P = 0.01); however, AKI stages could not predict the risk of DGF .…”

Section: Discussionmentioning

confidence: 99%

Single kidney transplantation from donors with acute kidney injury: A single‐center experience

Jiang

Song

Liu

et al. 2019

Pediatric Transplantation

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Introduction Despite a severe shortage of organ supply, patients are reluctant to accept organs from deceased donors with AKI, let alone from pediatric AKI donors. Methods We assessed 70 patients who received kidneys from donors with AKI (10 with pediatric and 60 with adult donors) and 176 contemporaneous patients who received kidneys from non‐AKI donors (41 with pediatric and 135 with adult donors) between March 2012 and February 2017 for retrospectively evaluating the clinical outcomes. Results AKI was defined and staging by the RIFLE criteria and pediatric‐modified RIFLE criteria. Median age was 11.00 years IQR (4.50‐14.00 years), and median weight was 25.00 kg (IQR, 17.00‐45.00 kg) for all pediatric donors. Median follow‐up was 8 months (range, 1‐49 months). Adult AKI group had the highest incidence of DGF (35.0% vs 10%, 9.8%, and 19.3%, P = 0.011). There was a significant increase in DGF in higher AKI stages (Risk: 20.7%, Injury: 46.7%, Failure: 50.0%; P = 0.014) among patients with adult donors. No significant differences were noted in 1‐year (100.0%, 95.1%, 98.3%, and 97.8%; P = 0.751) and 3‐year (100.0%, 95.1%, 98.3%, and 97.8%; P = 0.751) patient survival, and 1‐year (90.0%, 97.6%, 98.3%, and 95.6%; P = 0.535) and 3‐year (90.0%, 97.6%, 98.3%, and 95.6%; P = 0.535) graft survival. Conclusion Transplants procured from donors with AKI, particularly pediatric ones, could achieve excellent intermediate‐term clinical outcomes and thus potentially expand the donor pool.

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“…Our report also included a broad cohort of donors including DCD as well as DBD donors whereas the majority of previous studies have included only DBD donors . DCD is known to be associated with an increased incidence of delayed graft function.…”

Section: Discussionmentioning

confidence: 99%

Frequency and outcomes of kidney donation from intensive care patients with acute renal failure requiring renal replacement therapy

et al. 2019

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Background Kidney transplantation is the preferred treatment for end‐stage renal failure. Unfortunately, donor organ shortages prevent many individuals receiving a renal transplant and there is a need to increase the pool of appropriate donors. The presence of acute kidney injury (AKI) in deceased donors has traditionally been a relative contraindication to renal transplantation, even though renal recovery may be favorable in the absence of chronic renal disease. Methods We undertook an 8 years retrospective observational study of potential deceased organ donors with AKI requiring renal replacement therapy (RRT). We evaluated the rate of successful transplantation as well as short term and outcomes at a median of 19.5 (13.0–52.7) months after donation. Results Amongst 1058 consented potential organ donors, 39 patients had AKI requiring RRT, of which 19 became donors (13 not medically suitable, 7 did not proceed to donation). The median (interquartile range (IQR)) donor age was 41 (34–50) years and norepinephrine, epinephrine and vasopressin were given to 18, 14 and 9 donors, respectively. From the 38 donated kidneys 34 were transplanted. The median (IQR) age of recipients was 53 (42.8–58.5) years and they were dialysis free in a median (IQR) of 5.5 (2.3–10.8) days. Only minor abnormalities were found at 3 and 6 months renal biopsies, and two patients experienced graft failure in the first 12 months. Conclusion Amongst deceased donors with AKI receiving RRT and vasoactive medications outcomes of renal transplantation seems acceptable in the absence of pre‐existing renal failure and other donor co‐morbidity. Such patients may be an important additional source of kidney donation.

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Clinical outcome of kidney transplantation from deceased donors with acute kidney injury by Acute Kidney Injury Network criteria

Cited by 38 publications

References 24 publications

Excellent graft and patient survival after renal transplantation from donors after brain death with acute kidney injury: a case–control study

Excellent graft and patient survival after renal transplantation from donors after brain death with acute kidney injury: a case–control study

Single kidney transplantation from donors with acute kidney injury: A single‐center experience

Frequency and outcomes of kidney donation from intensive care patients with acute renal failure requiring renal replacement therapy

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