Transplantation with kidneys retrieved from deceased donors with acute renal failure

Transplantation. 2013 Feb 27;95(4):611-6. doi: 10.1097/TP.0b013e318279153c.

Abstract

Background: The discard rate of kidneys recovered from deceased donors with acute renal failure (ARF) is higher compared with those without ARF mainly due to the uncertainty regarding short-term and long-term outcomes.

Methods: We retrospectively analyzed 1-year patient, graft, and rejection-free survivals and renal function of transplantations performed with kidneys recovered from deceased donors with or without ARF, defined as serum creatinine level of more than 1.5 mg/dL. We performed multivariable analysis to evaluate whether ARF was an independent risk factor associated with inferior outcomes.

Results: Of a total of 1518 patients, 253 received kidneys from expanded-criteria donors (ECD; with ARF [n=116] and without ARF [n=137]) and 1265 from standard-criteria donors (SCD; with ARF [n=369] and without ARF [n=896]). The incidence of delayed graft function was higher in ECD (68.1% vs. 58.4%; P=0.072) and SCD (69.9% vs. 50.6%; P<0.001) recipients of kidneys with ARF compared with those without ARF, respectively. At 1 year, patient, graft, and rejection-free survivals were not statistically different in SCD or ECD recipients with or without ARF. Renal function at 1 year was similar in recipients of ECD (41.9±26.3 vs. 40.1±21.7 mL/min; P=0.565) or SCD (50.9±29.9 vs. 53.6±28.5 mL/min; P=0.131) kidneys with and without ARF, respectively. Compared with kidneys without ARF, receiving a kidney allograft with ARF was not associated with increased risk of death, graft lost, or inferior renal function 1 year after transplantation.

Conclusion: In this cohort of patients, kidneys from deceased donors with ARF provided graft survival and renal function comparable with kidneys from donors without ARF 1 year after transplantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / mortality*
  • Acute Kidney Injury / physiopathology
  • Adolescent
  • Adult
  • Biomarkers / blood
  • Chi-Square Distribution
  • Creatinine / blood
  • Delayed Graft Function / etiology
  • Female
  • Graft Rejection / etiology
  • Graft Survival
  • Humans
  • Kaplan-Meier Estimate
  • Kidney / physiopathology
  • Kidney / surgery*
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / mortality
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nephrectomy*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tissue Donors / supply & distribution*
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers
  • Creatinine