Transplanting Kidneys from Deceased Donors with Severe Acute Kidney Injury

R. L. Heilman*, M. L. Smith, S. M. Kurian, J. Huskey, R. K. Batra, H. A. Chakkera, N. N. Katariya, H. Khamash, A. Moss, D. R. Salomon, K. S. Reddy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

Our aim was to determine outcomes with transplanting kidneys from deceased donors with acute kidney injury, defined as a donor with terminal serum creatinine ≥2.0 mg/dL, or a donor requiring acute renal replacement therapy. We included all patients who received deceased donor kidney transplant from June 2004 to October 2013. There were 162 AKI donor transplant recipients (21% of deceased donor transplants): 139 in the standard criteria donor (SCD) and 23 in the expanded criteria donor (ECD) cohort. 71% of the AKI donors had stage 3 (severe AKI), based on acute kidney injury network (AKIN) staging. Protocol biopsies were done at 1, 4, and 12 months posttransplant. One and four month formalin-fixed paraffin embedded (FFPE) biopsies from 48 patients (24 AKI donors, 24 non-AKI) underwent global gene expression profiling using DNA microarrays (96 arrays). DGF was more common in the AKI group but eGFR, graft survival at 1 year and proportion with IF/TA>2 at 1 year were similar for the two groups. At 1 month, there were 898 differentially expressed genes in the AKI group (p-value <0.005; FDR <10%), but by 4 months there were no differences. Transplanting selected kidneys from deceased donors with AKI is safe and has excellent outcomes.

Original languageEnglish (US)
Pages (from-to)2143-2151
Number of pages9
JournalAmerican Journal of Transplantation
Volume15
Issue number8
DOIs
StatePublished - Aug 1 2015

Keywords

  • clinical research / practice
  • delayed graft function (DGF)
  • donors and donation: deceased
  • kidney transplantation / nephrology
  • molecular biology: mRNA / mRNA expression

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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