Kidney transplantation using expanded criteria deceased donors with terminal acute kidney injury: a single center experience in Korea

• Published in: Annals of surgical treatment and research Vol. 95; no. 5; pp. 278 - 285
• Main Authors: Ko, Kyung Jai, Kim, Young Hwa, Kim, Mi Hyeong, Jun, Kang Woong, Kwon, Kyung Hye, Kim, Hyung Sook, Kim, Sang Dong, Park, Sun Cheol, Kim, Ji Il, Yun, Sang Seob, Moon, In Sung, Hwang, Jeong Kye
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Surgical Society 01.11.2018; 대한외과학회
• Subjects: Original; 일반외과학; Donor selection [E04.936.537.500]; Acute kidney injury; Kidney transplantation
• ISSN: 2288-6575; 2288-6796
• DOI: 10.4174/astr.2018.95.5.278

We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI). Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38). The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024). Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.