Impact of deceased donor with acute kidney injury on subsequent kidney transplant outcomes–an ANZDATA registry analysis

Investigates the associations between donor acute kidney injury (AKI) and recipient transplant outcomes using the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and Organ Donation (ANZOD) Registry. Evaluates all-cause graft failure as well as death-censored graft failure, death...

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Published inPloS one Vol. 16; no. 3; p. e0249000
Main Authors Pei, Juan, Cho, Yeoungjee, See, Yong Pey, Pascoe, Elaine M., Viecelli, Andrea K., Francis, Ross S., van Eps, Carolyn, Isbel, Nicole M., Campbell, Scott B., Clayton, Philip A., Chapman, Jeremy, Collins, Michael, Lim, Wai, Tang, Wen, Wong, Germaine, Hawley, Carmel M., Johnson, David W.
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 25.03.2021
Public Library of Science (PLoS)
Subjects
Acute renal failure
Antibodies
Antigens
Biology and Life Sciences
Biopsy
Blood & organ donations
Body mass
Body mass index
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Cardiovascular disease
Cerebrovascular diseases
Complications
Coronary artery
Coronary artery disease
Criteria
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Demographic variables
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Hepatitis
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Hospitals
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Nephrology
Organ donors
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Patients
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Peritoneal dialysis
Peritoneum
Quality of life
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Survival
Translation
Transplantation
Urine
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Weight
New Zealand
Australia
Adelaide South Australia Australia
China
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ISSN1932-6203
1932-6203
DOI10.1371/journal.pone.0249000

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Abstract Investigates the associations between donor acute kidney injury (AKI) and recipient transplant outcomes using the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and Organ Donation (ANZOD) Registry. Evaluates all-cause graft failure as well as death-censored graft failure, death, delayed graft function (DGF), and acute rejection. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
AbstractList The need for kidney transplantation drives efforts to expand organ donation. The decision to accept organs from donors with acute kidney injury (AKI) can result in a clinical dilemma in the context of conflicting reports from published literature. This observational study included all deceased donor kidney transplants performed in Australia and New Zealand between 1997 and 2017. The association of donor-AKI, defined according to KDIGO criteria, with all-cause graft failure was evaluated by multivariable Cox regression. Secondary outcomes included death-censored graft failure, death, delayed graft function (DGF) and acute rejection. The study included 10,101 recipients of kidneys from 5,774 deceased donors, of whom 1182 (12%) recipients received kidneys from 662 (11%) donors with AKI. There were 3,259 (32%) all-cause graft failures, which included 1,509 deaths with functioning graft. After adjustment for donor, recipient and transplant characteristics, donor AKI was not associated with all-cause graft failure (adjusted hazard ratio [HR] 1.11, 95% CI 0.99-1.26), death-censored graft failure (HR 1.09, 95% CI 0.92-1.28), death (HR 1.15, 95% CI 0.98-1.35) or graft failure when death was evaluated as a competing event (sub-distribution hazard ratio [sHR] 1.07, 95% CI 0.91-1.26). Donor AKI was not associated with acute rejection but was associated with DGF (adjusted odds ratio [OR] 2.27, 95% CI 1.92-2.68). Donor AKI stage was not associated with any kidney transplant outcome, except DGF. Use of kidneys with AKI for transplantation appears to be justified.
Investigates the associations between donor acute kidney injury (AKI) and recipient transplant outcomes using the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and Organ Donation (ANZOD) Registry. Evaluates all-cause graft failure as well as death-censored graft failure, death, delayed graft function (DGF), and acute rejection. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
The need for kidney transplantation drives efforts to expand organ donation. The decision to accept organs from donors with acute kidney injury (AKI) can result in a clinical dilemma in the context of conflicting reports from published literature.BACKGROUNDThe need for kidney transplantation drives efforts to expand organ donation. The decision to accept organs from donors with acute kidney injury (AKI) can result in a clinical dilemma in the context of conflicting reports from published literature.This observational study included all deceased donor kidney transplants performed in Australia and New Zealand between 1997 and 2017. The association of donor-AKI, defined according to KDIGO criteria, with all-cause graft failure was evaluated by multivariable Cox regression. Secondary outcomes included death-censored graft failure, death, delayed graft function (DGF) and acute rejection.MATERIAL AND METHODSThis observational study included all deceased donor kidney transplants performed in Australia and New Zealand between 1997 and 2017. The association of donor-AKI, defined according to KDIGO criteria, with all-cause graft failure was evaluated by multivariable Cox regression. Secondary outcomes included death-censored graft failure, death, delayed graft function (DGF) and acute rejection.The study included 10,101 recipients of kidneys from 5,774 deceased donors, of whom 1182 (12%) recipients received kidneys from 662 (11%) donors with AKI. There were 3,259 (32%) all-cause graft failures, which included 1,509 deaths with functioning graft. After adjustment for donor, recipient and transplant characteristics, donor AKI was not associated with all-cause graft failure (adjusted hazard ratio [HR] 1.11, 95% CI 0.99-1.26), death-censored graft failure (HR 1.09, 95% CI 0.92-1.28), death (HR 1.15, 95% CI 0.98-1.35) or graft failure when death was evaluated as a competing event (sub-distribution hazard ratio [sHR] 1.07, 95% CI 0.91-1.26). Donor AKI was not associated with acute rejection but was associated with DGF (adjusted odds ratio [OR] 2.27, 95% CI 1.92-2.68).RESULTSThe study included 10,101 recipients of kidneys from 5,774 deceased donors, of whom 1182 (12%) recipients received kidneys from 662 (11%) donors with AKI. There were 3,259 (32%) all-cause graft failures, which included 1,509 deaths with functioning graft. After adjustment for donor, recipient and transplant characteristics, donor AKI was not associated with all-cause graft failure (adjusted hazard ratio [HR] 1.11, 95% CI 0.99-1.26), death-censored graft failure (HR 1.09, 95% CI 0.92-1.28), death (HR 1.15, 95% CI 0.98-1.35) or graft failure when death was evaluated as a competing event (sub-distribution hazard ratio [sHR] 1.07, 95% CI 0.91-1.26). Donor AKI was not associated with acute rejection but was associated with DGF (adjusted odds ratio [OR] 2.27, 95% CI 1.92-2.68).Donor AKI stage was not associated with any kidney transplant outcome, except DGF. Use of kidneys with AKI for transplantation appears to be justified.CONCLUSIONDonor AKI stage was not associated with any kidney transplant outcome, except DGF. Use of kidneys with AKI for transplantation appears to be justified.
BackgroundThe need for kidney transplantation drives efforts to expand organ donation. The decision to accept organs from donors with acute kidney injury (AKI) can result in a clinical dilemma in the context of conflicting reports from published literature.Material and methodsThis observational study included all deceased donor kidney transplants performed in Australia and New Zealand between 1997 and 2017. The association of donor-AKI, defined according to KDIGO criteria, with all-cause graft failure was evaluated by multivariable Cox regression. Secondary outcomes included death-censored graft failure, death, delayed graft function (DGF) and acute rejection.ResultsThe study included 10,101 recipients of kidneys from 5,774 deceased donors, of whom 1182 (12%) recipients received kidneys from 662 (11%) donors with AKI. There were 3,259 (32%) all-cause graft failures, which included 1,509 deaths with functioning graft. After adjustment for donor, recipient and transplant characteristics, donor AKI was not associated with all-cause graft failure (adjusted hazard ratio [HR] 1.11, 95% CI 0.99-1.26), death-censored graft failure (HR 1.09, 95% CI 0.92-1.28), death (HR 1.15, 95% CI 0.98-1.35) or graft failure when death was evaluated as a competing event (sub-distribution hazard ratio [sHR] 1.07, 95% CI 0.91-1.26). Donor AKI was not associated with acute rejection but was associated with DGF (adjusted odds ratio [OR] 2.27, 95% CI 1.92-2.68).ConclusionDonor AKI stage was not associated with any kidney transplant outcome, except DGF. Use of kidneys with AKI for transplantation appears to be justified.
Author Campbell, Scott B.
Clayton, Philip A.
van Eps, Carolyn
Pei, Juan
Cho, Yeoungjee
Johnson, David W.
Hawley, Carmel M.
Wong, Germaine
Francis, Ross S.
Collins, Michael
Chapman, Jeremy
Viecelli, Andrea K.
Tang, Wen
Isbel, Nicole M.
Lim, Wai
Pascoe, Elaine M.
See, Yong Pey
AuthorAffiliation 1 Department of Nephrology, Xiamen University and Fujian Medical University Affiliated First Hospital, Xiamen, China
3 Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, Australia
6 Department of Medicine, The University of Adelaide, Adelaide, Australia
9 Department of Renal Medicine, Auckland City Hospital, Auckland District Health Board, New Zealand
10 Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
4 Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
2 Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
5 Department of Renal Medicine, Tan Tock Seng Hospital, Novena, Singapore
8 Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
12 Translational Research Institute, Brisbane, Australia
7 Central and Northern Adelaide Renal and Transplanta
AuthorAffiliation_xml – name: 7 Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia
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crossref_primary_10_1097_MNH_0000000000000746
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Competing Interests: The authors have declared that no competing interests exist.
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Snippet Investigates the associations between donor acute kidney injury (AKI) and recipient transplant outcomes using the Australia and New Zealand Dialysis and...
The need for kidney transplantation drives efforts to expand organ donation. The decision to accept organs from donors with acute kidney injury (AKI) can...
BackgroundThe need for kidney transplantation drives efforts to expand organ donation. The decision to accept organs from donors with acute kidney injury (AKI)...
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SubjectTerms Acute renal failure
Antibodies
Antigens
Biology and Life Sciences
Biopsy
Blood & organ donations
Body mass
Body mass index
Body size
Cardiovascular disease
Cerebrovascular diseases
Complications
Coronary artery
Coronary artery disease
Criteria
Data analysis
Data collection
Demographic variables
Demographics
Diabetes
Diabetes mellitus
Dialysis
Editing
End-stage renal disease
Gender
Health risks
Heart diseases
Hemodialysis
Hepatitis
Hepatitis C
Histocompatibility antigen HLA
Hospitals
Hypertension
Immunosuppression
Injury analysis
Ischemia
Kidney diseases
Kidney transplantation
Kidney transplants
Kidneys
Leukocytes
Lung diseases
Medical research
Medical treatment
Medicine
Medicine and Health Sciences
Methodology
Mortality
Nephrology
Organ donors
Outcome assessment (Medical care)
Patients
Pediatrics
Peritoneal dialysis
Peritoneum
Quality of life
Race
Reviews
Smoking
Social Sciences
Survival
Translation
Transplantation
Urine
Vascular diseases
Weight
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Title Impact of deceased donor with acute kidney injury on subsequent kidney transplant outcomes–an ANZDATA registry analysis
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