Abstract: FR-PO1027

Clinical Outcome of Kidney Transplantation from Deceased Donors with Marginal Kidney Function

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Kang, Seong Sik, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Hayeon, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Yeo, Sang Mok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Jin, Kyubok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Sung Bae, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
Background

Deceased donor kidney transplantation (DDKT) in Korea has been activated recently. However, organ shortage for transplantation is getting worse, and DDKT using acute kidney injury (AKI), expanded criteria donor (ECD), or high kidney donor profile index (KDPI) kidney is increasing. Herein, we evaluated the clinical outcome of KT recipients (KTRs) who received marginal kidneys.

Methods

We retrospectively reviewed DDKT performed at Keimyung university hospital between January 2010 and December 2014. Ninety four DD and their corresponding 95 KTRs were included. We analyzed the clinical outcomes of DDKT according to AKI, ECD, and high KDPI (> 85%).

Results

KTRs belonging to the AKI group were 42 (44.2%), ECD group were 23 (24.2%), and high KDPI group were 16 (16.8%). The mean follow-up period was 42.6 ± 17.4 months (range 2-81). The incidence of delayed graft function (DGF) was significantly higher in the AKI group than in the non-AKI group (P = 0.011), but not in the ECD group and the high KDPI group. The estimated glomerular filtration rate (eGFR) of the AKI group was significantly lower at 1 week, 2 weeks and 1 month after KT compared to the non-AKI group. After 3 months of KT, there was no significant difference in eGFR between the AKI group and non-AKI group, the ECD group and standard criteria donor group, and the high KDPI group and low KDPI group. Patient survival rate showed no significant difference, according to AKI, ECD, or high KDPI. Allograft survival rate showed no significant difference in the AKI, ECD, and high KDPI groups compared with the control groups. However, allograft survival rate was significantly lower only in the group with acute rejection (AR) than in the group without AR (P < 0.001). In a multivariate analysis, AR was an independent risk factor for graft failure (hazard ratio 85.75, 95% confidence interval, 7.02-1047.77, P < 0.001), but AKI, ECD, or high KDPI were not.

Conclusion

AKI of DD kidney showed significant association with increased incidence of DGF. However, KT using AKI, ECD, or high KDPI donor kidney performed similarly to the control group in terms of graft function, graft survival, and patient survival. More detailed criteria for selecting a proper DD will be needed.