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Kidney Week

Abstract: TH-PO1158

Clinical Significance of AKI and Kidney Donor Profile Index on Clinical Outcomes in Deceased Donor Kidney Transplantation: A Multicenter Cohort Study

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Kim, Jeong Ho, Daejeon St. Mary's Hospital, Daejeon, Korea (the Republic of)
  • Park, Cheol Whee, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)
  • Yang, Chul Woo, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)
  • Jin, Kyubok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Chung, Byung ha, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)
Background

It is important to evaluate the donor quality before allocation in deceased donor kidney transplantation (DDKT). Kidney Donor Profile Index (KDPI) is an effective tool, but the association with acute kidney injury (AKI) is uncertain. The aim of this study was to investigate the clinical significance of AKI and KDPI on clinical outcomes in DDKT.

Methods

Four transplant centers enrolled 657 kidney transplant recipients (KTRs) from 526 deceased donors (DDs). We divided the high KDPI and low KDPI by the median of 65%, and each group was divided into AKI-KT and non-AKI-KT subgroups according to DDs with AKI.

Results

There was no significant difference in the incidence of delayed graft function between high KDPI-KT and low KDPI-KT groups, but AKI-KT subgroup showed significantly higher incidence of delayed graft function compared with non-AKI subgroup in the two groups (P=0.001, P<0.001). There was no significant difference in the incidence of biopsy-proven acute rejection between high KDPI-KT and low KDPI-KT groups regardless of DDs with AKI. Death-censored graft survival rate was significantly lower in the high KDPI-KT group compared with the low KDPI-KT group (P=0.005), but there was no significant difference in the death-censored graft survival rate between AKI-KT and non-AKI-KT subgroups in the each group. Only in the high KDPI-KT group, the KT group from DDs with AKI stage 3 was lower in death-censored graft survival rate compared with that from DDs with non-AKI, AKI stage 1, or 2.

Conclusion

KTs from DDs with AKI showed an adverse effect on the allograft outcome, especially from DDs with AKI stage 3 in the high KDPI-KT group. Therefore, closed observation and prevention of severe AKI will be required, especially for KTs from DDs with high KDPI.

Figure 1. Death-censored graft survival according to AKI stage in high KDPI group