Impact of acute kidney injury in expanded criteria deceased donors on post-transplant clinical outcomes: multicenter cohort study

Background The problem of organ shortage is an important issue in kidney transplantation, but the effect of kidney donation on AKI is unclear. The aim of this study was to investigate the impact of acute kidney injury (AKI) on post-transplant clinical outcomes for deceased donor kidney transplantati...

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Bibliographic Details
Published in:BMC Nephrology 2019, Vol.20 (1)
Main Authors: Park, Woo Yeong, Choi, Min-Seok, Kim, Young Soo, Choi, Bum Soon, Park, Cheol Whee, Yang, Chul Woo, Kim, Yong-Soo, Jin, Kyubok, Han, Seungyeup, Chung, Byung Ha
Format: Report
Language:English
Subjects:
Acute kidney failure
Homografts
Identification and classification
Influence
Kidney transplantation
Patient outcomes
Tissue donors
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Summary:Background The problem of organ shortage is an important issue in kidney transplantation, but the effect of kidney donation on AKI is unclear. The aim of this study was to investigate the impact of acute kidney injury (AKI) on post-transplant clinical outcomes for deceased donor kidney transplantation (DDKT) using standard criteria donors (SCDs) versus expanded criteria donors (ECDs). Methods Five-hundred nine KT recipients receiving kidneys from 386 deceased donors (DDs) were included from three transplant centers. Recipients were classified into the SCD-KT or ECD-KT group according to corresponding DDs and both groups were divided into the AKI-KT or non-AKI-KT subgroups according to AKI in donor. We compared the clinical outcomes among those four groups and investigated the interaction between AKI in donors and ECD on allograft outcome. Results The incidence of delayed allograft function was higher when the donors had AKI within SCD-KT and ECD-KT groups. In allograft biopsies within 3 months, chronic change was more significant in the AKI-ECD-KT subgroup than in the non-AKI-ECD-KT subgroup, but it did not differ between AKI-SCD-KT and non-AKI-SCD-KT group. AKI-ECD-KT showed higher risk for death-censored allograft failure than the other three groups and a significant interaction was observed between AKI in donors and ECD on the allograft outcome. Conclusions The presence of AKI in ECDs significantly impacted the long-term allograft outcomes of kidney transplant recipients, but it did not in SCDs. Keywords: Expanded criteria donor, Acute kidney injury, Deceased donor, Kidney transplantation
ISSN:1471-2369
1471-2369
DOI:10.1186/s12882-019-1225-1