Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study
Abstract The use of kidneys from donation after brain death (DBD) donors with acute kidney injury (AKI) is a strategy to expand the donor pool. The aim of this study was to evaluate how kidney transplantation (KT) from a donor with AKI affects long-term graft survival in various situations. All pati...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-03-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-84977-1 |
| _version_ | 1818420772619681792 |
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| author | Kyeong Deok Kim Kyo Won Lee Sang Jin Kim Okjoo Lee Manuel Lim Eun Sung Jeong Jieun Kwon Jaehun Yang Jongwook Oh Jae Berm Park |
| author_facet | Kyeong Deok Kim Kyo Won Lee Sang Jin Kim Okjoo Lee Manuel Lim Eun Sung Jeong Jieun Kwon Jaehun Yang Jongwook Oh Jae Berm Park |
| author_sort | Kyeong Deok Kim |
| collection | DOAJ |
| description | Abstract The use of kidneys from donation after brain death (DBD) donors with acute kidney injury (AKI) is a strategy to expand the donor pool. The aim of this study was to evaluate how kidney transplantation (KT) from a donor with AKI affects long-term graft survival in various situations. All patients who underwent KT from DBD donors between June 2003 and April 2016 were retrospectively reviewed. The KDIGO (Kidney Disease: Improving Global Outcomes) criteria were used to classify donor AKI. The cohort included 376 donors (no AKI group, n = 117 [31.1%]; AKI group n = 259 [68.9%]). Death-censored graft survival was similar according to the presence of AKI, AKI severity, and the AKI trend (p = 0.929, p = 0.077, and p = 0.658, respectively). Patients whose donors had AKI who received using low dose (1.5 mg/kg for three days) rabbit anti-thymocyte globulin (r-ATG) as the induction agent had significantly superior death-censored graft survival compared with patients in that group who received basiliximab (p = 0.039). AKI in DBD donors did not affect long-term death-censored graft survival. Low-dose r-ATG may be considered as an induction immunosuppression in recipients receiving kidneys with AKI because it showed better graft survival than basiliximab. |
| first_indexed | 2024-12-14T12:59:47Z |
| format | Article |
| id | doaj.art-42472adc0d3d419b8acb4ae83f9cbfa0 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T12:59:47Z |
| publishDate | 2021-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-42472adc0d3d419b8acb4ae83f9cbfa02022-12-21T23:00:28ZengNature PortfolioScientific Reports2045-23222021-03-0111111110.1038/s41598-021-84977-1Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort studyKyeong Deok Kim0Kyo Won Lee1Sang Jin Kim2Okjoo Lee3Manuel Lim4Eun Sung Jeong5Jieun Kwon6Jaehun Yang7Jongwook Oh8Jae Berm Park9Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract The use of kidneys from donation after brain death (DBD) donors with acute kidney injury (AKI) is a strategy to expand the donor pool. The aim of this study was to evaluate how kidney transplantation (KT) from a donor with AKI affects long-term graft survival in various situations. All patients who underwent KT from DBD donors between June 2003 and April 2016 were retrospectively reviewed. The KDIGO (Kidney Disease: Improving Global Outcomes) criteria were used to classify donor AKI. The cohort included 376 donors (no AKI group, n = 117 [31.1%]; AKI group n = 259 [68.9%]). Death-censored graft survival was similar according to the presence of AKI, AKI severity, and the AKI trend (p = 0.929, p = 0.077, and p = 0.658, respectively). Patients whose donors had AKI who received using low dose (1.5 mg/kg for three days) rabbit anti-thymocyte globulin (r-ATG) as the induction agent had significantly superior death-censored graft survival compared with patients in that group who received basiliximab (p = 0.039). AKI in DBD donors did not affect long-term death-censored graft survival. Low-dose r-ATG may be considered as an induction immunosuppression in recipients receiving kidneys with AKI because it showed better graft survival than basiliximab.https://doi.org/10.1038/s41598-021-84977-1 |
| spellingShingle | Kyeong Deok Kim Kyo Won Lee Sang Jin Kim Okjoo Lee Manuel Lim Eun Sung Jeong Jieun Kwon Jaehun Yang Jongwook Oh Jae Berm Park Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study Scientific Reports |
| title | Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study |
| title_full | Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study |
| title_fullStr | Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study |
| title_full_unstemmed | Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study |
| title_short | Safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury: a retrospective cohort study |
| title_sort | safety and effectiveness of kidney transplantation using a donation after brain death donor with acute kidney injury a retrospective cohort study |
| url | https://doi.org/10.1038/s41598-021-84977-1 |
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