AKI Need Not Rule Out Kidney Donation

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AKI patients may play a new role in expanding the kidney donor pool.
AKI patients may play a new role in expanding the kidney donor pool.

SAN DIEGO—Deceased donor kidneys with acute kidney injury (AKI) offer excellent short term patient and graft survival, investigators reported here at the 2010 American Transplant Congress.

A team led by Rafael Villicana, MD, Associate Director of Kidney Transplantation at the Comprehensive Transplant Center at Cedars-Sinai Medical Center in Los Angeles, looked at the outcomes of 23 transplanted kidneys from 13 deceased donors who met criteria for AKI and the donor terminal creatinine cut off (3.0 mg/dL or higher).

The donors had a mean age of 28.8 years (range 14-39 years) and mean terminal creatinine cut off of 4.4 mg/dL. Two donors were on dialysis at the time of organ procurement. Recipients had a mean age of 53.1 years. At one-year follow-up, patient and graft survival was 100%.

Eighteen patients (78%) experienced delayed graft function (DGF), which had a mean duration of 7.6 days (range 1-29 days). The mean serum creatinine level at one, three, six, and 12 months was 1.89, 1.39, 1.23, and 1.17 mg/dL, respectively. Five patients (22%) experienced acute rejection.

In a poster presentation, the authors concluded that AKI “should not be a contraindication to organ donation.”

“These types of organs could play an important role in expanding the deceased kidney donor pool,” they wrote.

In an interview, Dr. Villicana said it is unfortunate that kidneys from deceased individuals with AKI typically are discarded. Depending on the extent and type of acute damage, these kidneys can result in better transplant outcomes than kidneys from expanded criteria donors, he said.

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