Conflict of interest: Since 2012, Novartis has provided financial support for the maintenance and data entry of the transplant database, but Novartis had no impact on data acquisition and interpretation. The results presented in this paper have not been published previously in whole or part, except in abstract format.
Donor acute kidney injury and short-term graft outcome in renal transplantation
Version of Record online: 19 AUG 2014
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 28, Issue 10, pages 1131–1141, October 2014
How to Cite
Donor acute kidney injury and short-term graft outcome in renal transplantation., , , , , , , .
- Issue online: 18 OCT 2014
- Version of Record online: 19 AUG 2014
- Accepted manuscript online: 22 JUL 2014 10:56AM EST
- Manuscript Accepted: 21 JUL 2014
- acute kidney injury;
- allograft survival;
- expanded criteria donor
With increased waiting times for kidney transplantation, marginal organs from expanded criteria donors (ECD) are increasingly offered for allocation. In addition to ECD status, donors may have suffered from acute kidney injury (AKI) prior to organ procurement.
In this retrospective cohort study, we studied short-term allograft function in 517 kidney transplants performed between the years 2008–2014. Recipients of allografts from deceased organ donors were categorized as standard criteria donors (SCD) or ECD with or without AKI defined by RIFLE criteria.
Of 382 deceased donations, 174 (45.5%) were classified as ECD and 63 (16.5%) fulfilled AKI criteria. Donor creatinine on hospital admission was similar, whereas creatinine before organ procurement differed (p < 0.001). Despite these differences, serum creatinine and eGFR at discharge and after one yr showed only minor differences between kidneys with or without AKI. In multivariate linear regression analyses, donor AKI was not a predictor of one-yr allograft function.
Given the poor prognosis of dialysis patients and the increase in waiting time, kidneys from SCD and ECD donors with AKI should be allocated for transplantation. In case of ECD donors with AKI, recipients should be informed about the possibility of permanent non-function or early graft loss.