Kidney transplants from deceased donors with acute kidney injury (AKI) provide acceptable graft and patient survival, according to real-world data presented at the 2022 American Transplant Congress (ATC 2022) in Boston, Massachusetts. Donor AKI, however, may increase the risk for delayed graft function, post-transplantation hemodialysis, and hospital readmission.
Among 372 deceased donor kidney transplant recipients, 92 (24.7%) kidneys were from AKI donors and 280 (75.3%) from non-AKI donors. Graft and patient survival rates were similar between groups with and without donor AKI, Samir Iskhagi, MD, and colleagues from SUNY Upstate Medical University in Syracuse, New York reported. The groups also had comparable hospital stays (6.5 vs 5.8 days) and costs $259,267 vs $259,220).
Over a mean 40 months, the donor AKI group had significantly higher rates of delayed graft function (45.7% vs 30.7%), hemodialysis (37% vs 26.4%), and readmission (42.4% vs 35.4%).
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“Our study confirms that grafts from donors with AKI can be used safely and expand donor pool in kidney transplantation without increased cost,” Dr Iskhagi’s team concluded in a study abstract.
In a related study recently published in PLOS One, Chirag R. Parikh, MBBS, PhD, of Johns Hopkins University, Baltimore, Maryland, and colleagues examined donor AKI phenotypes and graft outcomes among 291 donors with AKI and 137 without AKI. Donors with intrinsic AKI vs no AKI had higher 4.8-fold increased odds of delayed graft function, but no greater risk of graft failure. Hemodynamic and mixed AKI were not associated with delayed graft function.
References
Iskhagi S, Shahbazov R, Ball A, et al. Deceased donor kidney transplantation from donors with acute kidney injury: realities and costs. Am J Transplant. 2022;22 (suppl 3). Presented at: ATC 2022 meeting; June 4-8; Boston, Massachusetts. Abstract 737.
Mansour SG, Khoury N, Kodali R, et al. Clinically adjudicated deceased donor acute kidney injury and graft outcomes. PLoS One. 2022 Mar 3;17(3):e0264329. doi:10.1371/journal.pone.0264329
