{Reference Type}: Journal Article
{Title}: Single center experience and literature review of kidney transplantation from non-ideal donors with acute kidney injury: Risk and reward.
{Author}: Webb CJ;McCracken E;Jay CL;Sharda B;Garner M;Farney AC;Orlando G;Reeves-Daniel A;Mena-Gutierrez A;Sakhovskaya N;Stratta B;Stratta RJ;
{Journal}: Clin Transplant
{Volume}: 37
{Issue}: 10
{Year}: 2023 10 30
{Factor}: 3.456
{DOI}: 10.1111/ctr.15115
{Abstract}: There is limited experience transplanting kidneys from either expanded criteria donors (ECD) or donation after circulatory death (DCD) deceased donors with terminal acute kidney injury (AKI).<BR>AKI kidneys were defined by a donor terminal serum creatinine level >2.0 mg/dL whereas non-ideal deceased donor (NIDD) kidneys were defined as AKI/DCD or AKI/ECDs.<BR>From February 2007 to March 2023, we transplanted 266 single AKI donor kidneys including 29 from ECDs, 29 from DCDs (n = 58 NIDDs), and 208 from brain-dead standard criteria donors (SCDs). Mean donor age (43.7 NIDD vs. 33.5 years SCD), KDPI (66% NIDD vs. 45% SCD), and recipient age (57 NIDD vs. 51 years SCD) were higher in the NIDD group (all p < .01). Mean waiting times (17.8 NIDD vs. 24.2 months SCD) and dialysis duration (34 NIDD vs. 47 months SCD) were shorter in the NIDD group (p < .05). Delayed graft function (DGF, 48%) and 1-year graft survival (92.7% NIDD vs. 95.9% SCD) was similar in both groups. Five-year patient and kidney graft survival rates were 82.1% versus 89.9% and 82.1% versus 75.2% (both p = NS) in the NIDD versus SCD groups, respectively.<BR>The use of kidneys from AKI donors can be safely liberalized to include selected ECD and DCD donors.