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Donor acute kidney injury and short‐term graft outcome in renal transplantation
Author(s) -
Jacobi Johannes,
Rebhan Dirk,
Heller Katharina,
Velden Joachim,
Hilgers Karl F.,
Wullich Bernd,
Eckardt KaiUwe,
Amann Kerstin U.
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12425
Subject(s) - medicine , rifle , creatinine , acute kidney injury , dialysis , renal function , transplantation , kidney transplantation , retrospective cohort study , cohort , urology , surgery , archaeology , history
Abstract Background 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. Methods 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. Results 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. Conclusions 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.