Moein Mahmoudreza, Iskhagi Samir, Shahbazov Rauf, Ball Angela, Loerzel Sharon, Shaban Eman, Hod Dvorai Reut, Hanlon Matthew, Saidi Reza F
From the Department of Surgery, Division of Transplantation, SUNY Upstate Medical University, Syracuse, New York, USA.
Exp Clin Transplant. 2023 Feb;21(2):104-109. doi: 10.6002/ect.2022.0341.
Transplant of kidneys from donors with acute kidney injury has shown favorable outcomes. We investigated the outcomes of kidney transplant recipients with deceased donors who developed acute kidney injury before organ procurement.
We retrospectively reviewed the medical records of recipients from January 2016 to December 2021 in a single center. Outcomes in recipients of kidney grafts from donors with and without acute kidney injury were compared.
The mean follow-up time was 40 months. Our study included 129 (34%) kidneys transplanted from donors with acute kidney injury and 251 (66%) kidneys from donors without acute kidney injury. Delayed graft function rate in recipients was 33% in the acute kidney injury group and 25.5% in the group without acute kidney injury (P = .099). Readmission rate at 30 days was significantly higher among recipients of kidneys with acute kidney injury compared with recipients of kidneys without acute kidney injury (45% vs 33.5%; P = .02). The mean overall costs of transplant in the acute kidney injury group were comparable to the group without acute kidney injury ($253 865 vs $253 611; P = .97). The acute rejection rate was comparable between the 2 groups (4% in both groups; P = .96). Delayed graft function rate was increased with increased stage of acute kidney injury (18% stage 1, 45% stage 2, 36% stage 3; P = .03). However, the overall length of hospital stay and costs were comparable among recipients of different stages of acute kidney injury.
Our study showed that kidney transplants from donors with acute kidney injury have early and late outcomes comparable to kidney transplants from donors without acute kidney injury. Allografts from donors with acute kidney injury can be used safely and can expand the donor pool in kidney transplant without increasing perioperative resource utilization.
来自急性肾损伤供体的肾脏移植已显示出良好的结果。我们调查了在器官获取前发生急性肾损伤的已故供体的肾移植受者的结局。
我们回顾性分析了2016年1月至2021年12月在单一中心接受肾移植患者的病历。比较了接受有急性肾损伤供体和无急性肾损伤供体肾移植受者的结局。
平均随访时间为40个月。我们的研究包括129例（34%）接受了来自急性肾损伤供体的肾脏移植，以及251例（66%）接受了来自无急性肾损伤供体的肾脏移植。急性肾损伤组受者的移植肾功能延迟发生率为33%，无急性肾损伤组为25.5%（P = 0.099）。与无急性肾损伤供体肾移植受者相比，急性肾损伤供体肾移植受者30天再入院率显著更高（45%对33.5%；P = 0.02）。急性肾损伤组移植的平均总费用与无急性肾损伤组相当（253865美元对253611美元；P = 0.97）。两组的急性排斥反应发生率相当（均为4%；P = 0.96）。移植肾功能延迟发生率随急性肾损伤分期增加而升高（1期为18%，2期为45%，3期为36%；P = 0.03）。然而，不同急性肾损伤分期受者的住院总时长和费用相当。
我们的研究表明，来自急性肾损伤供体的肾脏移植的早期和晚期结局与来自无急性肾损伤供体的肾脏移植相当。来自急性肾损伤供体的同种异体移植物可安全使用，并且可在不增加围手术期资源利用的情况下扩大肾移植的供体库。
