Kidney Week

Abstract: FR-PO0983

One-Year Graft and Patient Outcomes from Deceased Kidney Donors on Dialysis: A Single-Center Experience

Session Information

• Transplantation: Clinical - Pretransplantation, Living Donation, and Policies
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Ajaimy, Maria, Montefiore Einstein Medical Center, New York, New York, United States

Maria Ajaimy, MD, FASN

• Barbash, Daniel, Kidney Care and Transplant Services of New England PC, West Springfield, Massachusetts, United States

Daniel Barbash, DO

• Yaffe, Hillary C, Montefiore Einstein Medical Center, New York, New York, United States

Hillary C Yaffe, MD, MMSc

• Le, Marie, Montefiore Einstein Medical Center, New York, New York, United States

Marie Le, MD

• von Ahrens, Dagny, Montefiore Einstein Medical Center, New York, New York, United States

Dagny von Ahrens, MD

• Verzani, Zoe, Weill Cornell Medicine, New York, New York, United States

Zoe Verzani, MPH

• Abdel Muhdi, Nidal, Montefiore Einstein Medical Center, New York, New York, United States

Nidal Abdel Muhdi, MD

• Graham, Jay A., Montefiore Einstein Medical Center, New York, New York, United States

Jay A. Graham, MD, MBA

• Murthy, Anu, Montefiore Einstein Medical Center, New York, New York, United States

Anu Murthy, MD

• Al Azzi, Yorg, Montefiore Einstein Medical Center, New York, New York, United States

Yorg Al Azzi, MD, FASN

• Akalin, Enver, Montefiore Einstein Medical Center, New York, New York, United States

Enver Akalin, MD, FASN

Background

We investigated clinical outcomes of deceased donors who were on renal replacement therapy (RRT) for acute kidney injury (AKI).

Methods

Adult solitary kidney transplants from deceased donors from January to December 2023 were retrospectively analyzed. Outcomes of donors on RRT were compared to donors with AKI but no dialysis (terminal Cr >=2 mg/dL), and no AKI. Multivariable Cox Proportional Hazards regression and Kaplan-Meier survival analysis was used to study primary outcomes (1 year patient and graft survival) and secondary outcomes: delayed graft function (DGF) rate and duration, acute rejection, and eGFR (mL/min/BSA) at 6 months and 1 year

Results

Table shows demographics of 124 non-AKI donors, 34 donors on dialysis and 59 AKI but no dialysis. Dialysis donors were younger compared to AKI and non-AKI donors (38, 45, 47 years, p=.017), had lower rates of hypertension (HTN) (12%, 30%, 40%, p=.006), and lower mean KDPI (49%, 68%, 64%, p<.001), respectively. Dialysis donors had higher BMI (31, 30, 27, p=.032) and were more likely to be donors after brain death (82%, 68%, 58%, p=.027). The median time on dialysis was 3.03 days. Primary and secondary outcomes are described in the Table. There was a difference in death censored graft failure with the highest rate in the AKI group followed by dialysis group (14%, 5.9%, 0.6%, p<.001) (Figure). In the multivariate analysis, younger donors were associated with better graft survival (HR=0.95[0.91-0.99], p=.022). Donor HTN was associated with worse graft survival (HR=5.85[1.28-26.9], p=.023). Donor biopsy analysis did not affect the composite outcome.

Conclusion

Kidneys from deceased donors on dialysis, paired with younger age, less HTN, offer comparable one-year graft survival to AKI without dialysis and non-AKI donors

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.202533h91tfj