Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study

• Published in: Scientific reports Vol. 11; no. 1; p. 5572
• Main Authors: Kim, Kyeong Deok, Lee, Kyo Won, Kim, Sang Jin, Lee, Okjoo, Lim, Manuel, Jeong, Eun Sung, Kwon, Jieun, Yang, Jaehun, Oh, Jongwook, Park, Jae Berm
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 10.03.2021; Nature Publishing Group UK; Nature Portfolio
• Subjects: Brain death; Cohort analysis; Death; Donors; Drug dosages; Globulins; Immunosuppression; Kidney diseases; Kidney transplantation; Kidney transplants; Kidneys; Mortality; Survival; Thymocytes
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-84977-1

The use of kidneys from donation after brain death (DBD) donors with acute kidney injury (AKI) is a strategy to expand the donor pool. The aim of this study was to evaluate how kidney transplantation (KT) from a donor with AKI affects long-term graft survival in various situations. All patients who underwent KT from DBD donors between June 2003 and April 2016 were retrospectively reviewed. The KDIGO (Kidney Disease: Improving Global Outcomes) criteria were used to classify donor AKI. The cohort included 376 donors (no AKI group, n = 117 [31.1%]; AKI group n = 259 [68.9%]). Death-censored graft survival was similar according to the presence of AKI, AKI severity, and the AKI trend (p = 0.929, p = 0.077, and p = 0.658, respectively). Patients whose donors had AKI who received using low dose (1.5 mg/kg for three days) rabbit anti-thymocyte globulin (r-ATG) as the induction agent had significantly superior death-censored graft survival compared with patients in that group who received basiliximab (p = 0.039). AKI in DBD donors did not affect long-term death-censored graft survival. Low-dose r-ATG may be considered as an induction immunosuppression in recipients receiving kidneys with AKI because it showed better graft survival than basiliximab.