Transplantation of Kidneys From Deceased Donors With Terminal Acute Kidney Injury - The Solution to the Organ Shortage.

Abstract

Introduction The most of analysis compare transplantation of kidneys procured from standard (SCD) and expanded criteria deceased donors (ECD). Different subgroup of donors are those with higher terminal creatinine concentration known as donors with acute kidney injury. The aim of this paper is to report the results of kidney transplantation in cases when organ was procured from deceased donors with acute kidney injury. Patients and methods Two hundred and twenty six patients received cadaveric renal transplants between 2010 and 2011. Data on donors, organ storage, recipients and results of kidneys transplantation were collected. More than 25% of transplanted kidneys were procured from expanded criteria donors. The terminal creatinine concentration ranged from 0.40-6.04 mg/dl. The terminal acute kidney injury (AKI) was identified when the terminal creatinine concentration was more than 1.99 mg/dl. All patients were followed-up for twenty four months. Results There were more episodes of delayed graft function observed in the AKI groups (61.3% vs 38.4%, p < 0.05). The creatinine concentration was significantly higher in the AKI groups in the early period after transplantation but there were no differences one year after transplantation. There were no differences in the incidence of acute rejection episodes, patient and graft survival between the groups. Conclusions Kidneys with AKI are more likely to have delayed graft function but they have similar survival in comparison to non-AKI kidney. Kidneys with AKI may expand organ pool when careful donor kidney selection is applied and appropriate deceased donor care is performed.