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Kidney transplantation using expanded criteria deceased donors with terminal acute kidney injury: a single center experience in Korea

Annals of Surgical Treatment and Research 2018년 95권 5호 p.278 ~ 285
KMID : 0371420180950050278
 ( Ko Kyung-Jai ) - Catholic University College of Medicine Departments of Surgery

 ( Kim Young-Hwa ) - Catholic University College of Medicine Departments of Surgery
 ( Kim Mi-Hyeong ) - Catholic University College of Medicine Department of Surgery
 ( Jun Kang-Woong ) - Catholic University College of Medicine Department of Surgery
 ( Kwon Kyung-Hye ) - Catholic University College of Medicine Departments of Surgery
 ( Kim Hyung-Sook ) - Catholic University Seoul St. Mary’s Hospital Organ Transplant Center
 ( Kim Sang-Dong ) - Catholic University College of Medicine Department of Surgery
 ( Park Sun-Cheol ) - Catholic University College of Medicine Department of Surgery
 ( Kim Ji-Il ) - Catholic University College of Medicine Department of Surgery
 ( Yun Sang-Seob ) - Catholic University College of Medicine Department of Surgery
 ( Moon In-Sung ) - Catholic University College of Medicine Department of Surgery
 ( Hwang Jeong-Kye ) - Catholic University College of Medicine Department of Surgery

Abstract

Purpose: We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI).

Methods: Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38).

Results: The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024).

Conclusion: Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.
KeyWords

Acute kidney injury, Donor selection [E04.936.537.500], Kidney transplantation
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