Kidney Transplantation From Donors With Acute Kidney Injury: Are the Concerns Justified? A Systematic Review and Meta-Analysis

Renal transplantation improves quality of life and prolongs survival in patients with end-stage kidney disease, although challenges exist due to the paucity of suitable donor organs. This has been addressed by expanding the donor pool to include AKI kidneys. We aimed to establish whether transplanti...

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Bibliographic Details
Published in:Transplant international 2023-05, Vol.36, p.11232-11232
Main Authors: Nita, George Emilian, Gopal, Jeevan Prakash, Khambalia, Hussein A, Moinuddin, Zia, van Dellen, David
Format: Article
Language:English
Subjects:
Acute Kidney Injury
Delayed Graft Function
Graft Rejection
Graft Survival
Health Archive
Humans
Kidney
Kidney Transplantation
Quality of Life
Retrospective Studies
Tissue Donors
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Summary:Renal transplantation improves quality of life and prolongs survival in patients with end-stage kidney disease, although challenges exist due to the paucity of suitable donor organs. This has been addressed by expanding the donor pool to include AKI kidneys. We aimed to establish whether transplanting such kidneys had a detrimental effect on graft outcome. The primary aim was to define early outcomes: delayed graft function (DGF) and primary non-function (PNF). The secondary aims were to define the relationship to acute rejection, allograft survival, eGFR and length of hospital stay (LOS). A systematic literature review and meta-analysis was conducted on the studies reporting the above outcomes from PubMed, Embase, and Cochrane Library databases. This analysis included 30 studies. There is a higher risk of DGF in the AKI group (OR = 2.20, < 0.00001). There is no difference in the risk for PNF (OR 0.99, = 0.98), acute rejection (OR 1.29, = 0.08), eGFR decline ( = 0.05) and prolonged LOS ( = 0.11). The odds of allograft survival are similar (OR 0.95, = 0.54). Transplanting kidneys from donors with AKI can lead to satisfactory outcomes. This is an underutilised resource which can address organ demand.
ISSN:1432-2277
0934-0874
1432-2277
DOI:10.3389/ti.2023.11232