Clinical Outcomes in Kidney Transplantation Patients From Deceased Donors With Acute Kidney Injury

Jung, Cheol Woong; Park, K.T.; Kim, S.Y.; Kim, S.J.; Kim, M.G.; Jo, Sang Kyung; Cho, W.; Kim, H.K.

doi:10.1016/j.transproceed.2013.08.048

Cited by 23 publications

(15 citation statements)

References 12 publications

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“…In a study by Hall et al [14], DGF rates were slightly lower for the AKIN stages 1, 2, and 3, which were 34%, 52%, and 57%, respectively. Similar results were found in a study by Jung et al [15], with DGF higher in patients with AKI compared to the group without AKI. Nevertheless, in the present study, the renal function of transplant recipients was good after 6 months posttransplantation at the 3 AKIN stages, with an average creatinine clearance of 60 mL/min.…”

Section: Discussionsupporting

confidence: 91%

Good Outcomes in Kidney Transplantation With Deceased Donor With Acute Kidney Injury: Donor's Age and Not Acute Kidney Injury Predicts Graft Function

Nga

Takase

Bravin

et al. 2016

Transplantation Proceedings

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Section: Discussionsupporting

confidence: 91%

Good Outcomes in Kidney Transplantation With Deceased Donor With Acute Kidney Injury: Donor's Age and Not Acute Kidney Injury Predicts Graft Function

Nga

Takase

Bravin

et al. 2016

Transplantation Proceedings

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“…Farney et al reported that the renal function of patients who received kidneys from adult donors with or without AKI was not different at two years . Similarly, Jung et al also reported that the 3‐, 6‐, and 12‐month renal function status was not significantly different between the AKI and non‐AKI adult donor groups . However, the present study detected that the renal function was poor in the pediatric AKI group in the short term, with the lowest eGFR occurring at one week post‐transplant, but it greatly improved at six months post‐transplant, and the mid‐term renal function was similar to that in the pediatric non‐AKI and adult donor groups.…”

Section: Discussionsupporting

confidence: 43%

“…23 Similarly, Jung et al also reported that the 3-, 6-, and 12-month renal function status was not significantly different between the AKI and non-AKI adult donor groups. 24 However, the present study detected that the renal function was poor in the pediatric AKI group in the short term, with the lowest eGFR occurring at one week post-transplant, but it greatly improved at six months post-transplant, and the mid-term renal function was similar to that in the pediatric non-AKI and adult donor groups. The small mass allograft from pediatric donors to adult recipients is vulnerable to hyperfiltration injury, resulting in severe proteinuria and even graft loss, which has already been described many years ago.…”

Section: Discussioncontrasting

confidence: 42%

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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“…Although in some cases a high terminal creatinine level may reflect chronic poor renal function, in general this seems unlikely in a potential donor population. Kidneys from acute kidney injury donors have been shown to have satisfactory long‐term graft survival, albeit with higher initial risk of delayed graft function …”

Section: Discussionmentioning

confidence: 99%

An international comparison of deceased donor kidney utilization: What can the United States and the United Kingdom learn from each other?

Ibrahim

Vece²,

Mehew

et al. 2020

American Journal of Transplantation

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In transplant, meaningful international comparisons in organ utilization are needed. This collaborative study between the United Kingdom (UK) and the United States (US) aimed to develop a kidney utilization metric allowing for legitimate intercountry comparisons.Data from the UK and US transplant registries, including all deceased donor kidneys recovered from 2006 to 2017, were analyzed. To identify a potentially comparable kidney utilization rate (UR), several denominators were assessed. We discovered that the proportion of transplanted kidneys from elderly donors in the UK (10.7%) was 18 times greater than that in the US (0.6%). Conversely, en bloc pediatric kidney transplant was more common in the US. Donation after circulatory death utilization has risen in both countries but is twice as prevalent in the UK (39% of transplants) vs the US (20%). In addition, US and UK URs are not directly comparable due to fundamental system differences. However, using a suite of URs revealed practice areas likely to yield the most benefit if improved, such as efforts to increase kidney offer acceptance in the US and to reduce postacceptance discard in the UK. Methods used in this study, including novel intracountry risk-adjusted UR trend logistic regression analyses, can be translated to other international transplant registries in pursuit of further global learning opportunities. K E Y W O R D S clinical research/practice, donors and donation: deceased, donors and donation: donation after brain death (DBD), donors and donation: donation after circulatory death (DCD), kidney transplantation/nephrology, United Network for Organ Sharing (UNOS) S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section.

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Clinical Outcomes in Kidney Transplantation Patients From Deceased Donors With Acute Kidney Injury

Cited by 23 publications

References 12 publications

Good Outcomes in Kidney Transplantation With Deceased Donor With Acute Kidney Injury: Donor's Age and Not Acute Kidney Injury Predicts Graft Function

Good Outcomes in Kidney Transplantation With Deceased Donor With Acute Kidney Injury: Donor's Age and Not Acute Kidney Injury Predicts Graft Function

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

An international comparison of deceased donor kidney utilization: What can the United States and the United Kingdom learn from each other?

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