Decision Making by Young Transplant Surgeons Regarding Expanded-Criteria Donors With Acute Kidney Injury or Allocation Failure

Jung, Dae Chul; Park, S.; Kim, S.H.; Eom, Min Seob; Kim, J.S.; Yang, Jaeseok; Han, Byoung Geun; Choi, Seung Ok

doi:10.1016/j.transproceed.2015.11.025

Cited by 1 publication

(3 citation statements)

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“…The likelihood of DGF is the most important consideration when a surgeon decides to use or discard a kidney with AKI from an ECD. Several authors have reported that KT using an ECD with AKI results in comparable short-and long-term outcomes [10][11][12][13][14] , although other studies have shown contrary results 15 . Although many authors have reported it is acceptable to use an ECD kidney with AKI 16 , no practical tools are available to evaluate ECD kidneys with AKI.…”

Section: Discussionmentioning

confidence: 99%

“…The eGFR was calculated using the Modification of Diet in Renal Disease four4-variable equation 34 . SCD, ECD, DGF, and acute AKI were defined as we described in a previous article 13 . (2020) 10:8109 | https://doi.org/10.1038/s41598-020-65134-6 www.nature.com/scientificreports www.nature.com/scientificreports/ Recipients at immunologic risk were defined as those that had undergone a second or ABO-incompatible KT, had a panel reactive antibody level > 20%, or had received a kidney from a deceased donor with an AKI grade > 3.…”

Section: Methodsmentioning

confidence: 99%

“…We used a triple regimen of tacrolimus, corticosteroid, and mycophenolate mofetil as the maintenance immunosuppressant agents. Trough levels of tacrolimus and mycophenolate mofetil dosage were controlled as we previously described 13 with the exception that corticosteroid administration was started as 500 mg of methylprednisolone followed by dose tapering as previously described 13 . We checked cytomegalovirus (CMV) and BK virus infection status repeatedly.…”

Section: Methodsmentioning

confidence: 99%

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Effectiveness of serum beta-2 microglobulin as a tool for evaluating donor kidney status for transplantation

Whan

Shin

Kim

et al. 2020

Sci Rep

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Kidney transplantations using expanded criteria donors (ECD) are being increasingly adopted, but no consensus tools are available to evaluate donor kidney status. Beta-2 microglobulin (B2MG) is a marker of kidney function, and herein, we evaluate the usefulness of assessing B2MG to evaluate donor kidney status. Fifty-seven kidney transplantations were performed from March 2017 to April 2019. Medical records were retrospectively reviewed, and relationships between clinical and laboratory variables and transplant outcomes were investigated. Thirty-eight patients received a standard criteria donor kidney and 19 patients an ECD kidney. Ten patients experienced delayed graft function (DGF), but no patient experienced primary nonfunction. Of the parameters studied, only donor renal replacement therapy (RRT) [odds ratio (OR) 24.162; p = 0.018] and donor serum B2MG (OR 22.685; p = 0.022) significantly predicted DGF. The presence of either of these two risk factors can better reflect the condition of the donor than previous classification. However, on their last follow-up creatinine and estimated glomerular filtration rate values in those with or without these risk factors were not significantly different. For an ECD with a B2MG level of <7.18 and no history of RRT, kidney transplantation can be undertaken without considering the possibility of kidney discard.

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