Successful transplantation of kidneys from deceased donors with terminal acute kidney injury

Ren Fail. 2019 Nov;41(1):167-174. doi: 10.1080/0886022X.2019.1590209.

Abstract

Background: There are many doubts with regards to accepting deceased kidneys with acute kidney injury (AKI) for transplantation.

Purpose: The aim of this study was to present the 5-years outcome of kidney transplantation cases where deceased donors developed AKI before organ procurement.

Methods: Two hundred twenty-six deceased renal transplants were analyzed. Data regarding donors and recipients were collected. Terminal AKI was defined as terminal serum creatinine concentration higher than 1.99 mg/dL and 66 such cases were diagnosed. All kidney transplant recipients were followed for 60 months.

Results: AKI group presented more episodes of delayed graft function (DGF) compared to the non-AKI group (56% vs 35%, p < .05). No differences were observed between the groups in the rate of acute rejection episodes, kidney function as well as patient and graft survival.

Conclusions: Transplants with AKI present more often DGF and comparable graft survival to transplants without AKI. Kidneys with AKI can be a valuable source of organs provided attentive selection and appropriate care of deceased donors.

Keywords: Acute kidney injury; deceased donors; expanded criteria donors; kidney graft survival; kidney transplantation.

Publication types

  • Comparative Study

MeSH terms

  • Acute Kidney Injury / mortality*
  • Adolescent
  • Adult
  • Aged
  • Allografts / pathology
  • Allografts / supply & distribution
  • Delayed Graft Function / epidemiology*
  • Delayed Graft Function / pathology
  • Donor Selection / standards*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Rejection / epidemiology*
  • Graft Rejection / pathology
  • Graft Survival
  • Humans
  • Kidney / pathology
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate
  • Tissue Donors
  • Treatment Outcome
  • Young Adult