Transplanted kidneys from deceased donors with terminal AKI found safe, effective
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Kidney transplantation with organs from donors who died after developing AKI conferred similar outcomes as transplant with non-AKI organs, according to study results.
“The purpose of this study was to look at long-term outcomes of kidney transplantation from deceased donors with terminal acute kidney injury,” Trent VanHorn, of the department of surgery at Wake Forest Baptist Medical Center in Winston Salem, North Carolina, said at the virtual American Society of Transplant Surgeons Winter Symposium.
The retrospective review included 185 AKI kidneys (147 standard criteria donor kidneys, 26 expanded donor criteria kidneys and 12 kidneys from donors after cardiac death). VanHorn further described the characteristics of donors as having a mean age of 36 years and a mean serum creatinine level of 1.3 mg/dL at hospital admission. At time of death, mean serum creatinine was 3.1 mg/dL and mean eGFR was 32 mL/min/1.73 m2.
After a mean follow-up of 78 months, researchers found actuarial graft survival was comparable to transplants performed with brain-dead non-AKI standard criteria donor kidneys, with similar patient survival between groups.
While delayed graft function (DGF) occurred in more patients who received AKI kidneys (47% vs. 22%), the impact of DGF was earlier and more pronounced in non-AKI recipients.
“Despite having a significantly higher incidence of DGF, kidneys from deceased donors with terminal AKI have long-term outcomes that are comparable to non-AKI SCD kidneys and represent a safe and effective method to expand the donor pool,” VanHorn concluded of the findings.
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VanHorn T, et al. Poster 55. Presented at: ASTS Winter Symposium. Jan. 14-16, 2021 (virtual meeting).
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