Outcomes of kidneys utilized from deceased donors with severe acute kidney injury

Significant numbers of kidneys are discarded due to raised terminal creatinine of the donor.

To determine long-term outcomes of kidneys utilized from donors with severe acute kidney injury (AKI).

In this retrospective study, we included all patients who received kidneys from deceased donors between years 2000 and 2012. AKI was defined according to the acute kidney injury network (AKIN) classification. The primary outcomes were patient and graft survival and secondary outcomes were renal function at different time points, delayed graft function, acute rejection and length of hospital stay.

Two hundred and eighty-four recipients received kidneys from 261 deceased donors. One hundred and fourteen patients (40%) received kidneys from the donors with AKI. Forty-two patients received kidneys from the donors with severe AKI (AKIN-3 category). Mean age of the donor and recipient was 36 and 37 years, respectively. Main cause of death in donors was road traffic accident (34%) followed by cerebrovascular accident (33%). Terminal creatinine was 85 and 262 μmol/l in non-AKI and AKI groups, respectively (P < 0.001). Significantly more patients in the AKI group had delayed graft function (P = 0.006), prolonged hospital stay (P < 0.001) and high creatinine at discharge (P = 0.002). However, acute rejection rates (P = 0.25), 1-, 5- and 10-year graft survival (P = 0.57) and patient survival (P = 0.77) were not different between AKI and non-AKI groups. The outcomes in the AKIN-3 category were comparable with the non-AKI group.

This study has shown favorable long-term outcomes of kidneys utilized from donors with severe AKI. This study may encourage healthcare professionals to consider accepting such kidneys.