Encarnación Juan A, Coll Elisabeth, Manso Clara, Llorente Santiago, Morales Francisco, Saura Isabel, López-Cubillana Pedro, Martínez-Valls Pablo Luis Guzman, Martínez Gloria, De la Fuente Isabel, Cárdenas Enrique, Alonso-Romero Jose L, Ruiz Paula, Moya José, Domínguez-Gil Beatriz, Royo-Villanova Mario
Department of Radiation Oncology, Virgen de la Arrixaca University Clinical Hospital, 30120 Murcia, Spain.
Murcian Institute of Biosanitary Research, 30120 Murcia, Spain.
Med Sci (Basel). 2025 Sep 14;13(3):188. doi: 10.3390/medsci13030188.
The shortage of donor kidneys has prompted interest in using organs from donors with severe acute kidney injury (AKI), but robust data on outcomes from donors with AKIN stage 3 remain limited.
This single-centre, retrospective cohort study compared outcomes of kidney transplants from deceased donors with AKIN stage 3 AKI to matched non-AKI donors ( = 57 per group; matched by donor age ±5 years, year of transplant, and major cardiovascular risk factors). Primary outcomes were delayed graft function (DGF), death-censored graft survival, and patient survival. Secondary outcomes included renal function at follow-up.
DGF occurred in 54.4% (31/57) of AKIN 3 recipients vs. 33.3% (19/57) of non-AKI recipients (risk difference 21.1%, 95% CI 3.1-39.2; = 0.037). Five-year death-censored graft survival was 94.7% vs. 96.4% (HR 1.28, 95% CI 0.25-6.52; = 0.645). Five-year patient survival was 84.8% vs. 84.0% (HR 0.96, 95% CI 0.30-3.05; = 0.979). Median follow-up was 32 months.
In this preliminary, selected kidneys from AKIN stage 3 donors yielded similar medium-term graft and patient survival to non-AKI donors, despite higher DGF incidence. Findings should be interpreted cautiously and confirmed in adequately powered, multicentre studies with extended follow-up.
供体肾短缺促使人们对使用患有严重急性肾损伤（AKI）的供体器官产生兴趣，但关于急性肾损伤网络（AKIN）3期供体预后的有力数据仍然有限。
这项单中心回顾性队列研究比较了来自患有AKIN 3期AKI的已故供体的肾移植结果与匹配的非AKI供体（每组57例；按供体年龄±5岁、移植年份和主要心血管危险因素进行匹配）。主要结局为移植肾功能延迟恢复（DGF）、死亡截尾移植物存活率和患者存活率。次要结局包括随访时的肾功能。
AKIN 3期受者中54.4%（31/57）发生DGF，而非AKI受者中为33.3%（19/57）（风险差异21.1%，95%可信区间3.1 - 39.2；P = 0.037）。5年死亡截尾移植物存活率分别为94.7%和96.4%（风险比1.28，95%可信区间0.25 - 6.52；P = 0.645）。5年患者存活率分别为84.8%和84.0%（风险比0.96，95%可信区间0.30 - 3.05；P = 0.979）。中位随访时间为32个月。
在这项初步研究中，尽管DGF发生率较高，但来自AKIN 3期供体的精选肾脏产生的中期移植物和患者存活率与非AKI供体相似。研究结果应谨慎解读，并在有足够样本量、进行长期随访的多中心研究中得到证实。
