Past, Current, and Future Perspectives on Transplanting Acute Kidney Injury Kidneys
(1) Background: Acute kidney injury (AKI) kidneys have high non-utilization rates due to concerns regarding unfavorable outcomes. In this paper, we aimed to review the past, present, and future opinions on AKI kidneys. (2) Methods: A PubMed search was conducted for topics relevant to AKI kidney tran...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Clinics and Practice |
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| Online Access: | https://www.mdpi.com/2039-7283/13/4/86 |
| _version_ | 1797585120492781568 |
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| author | Rachana Punukollu Margaret Ryan Suman Misra Pooja Budhiraja Stephanie Ohara Kayla Kumm Giselle Guerra Kunam S. Reddy Raymond Heilman Caroline C. Jadlowiec |
| author_facet | Rachana Punukollu Margaret Ryan Suman Misra Pooja Budhiraja Stephanie Ohara Kayla Kumm Giselle Guerra Kunam S. Reddy Raymond Heilman Caroline C. Jadlowiec |
| author_sort | Rachana Punukollu |
| collection | DOAJ |
| description | (1) Background: Acute kidney injury (AKI) kidneys have high non-utilization rates due to concerns regarding unfavorable outcomes. In this paper, we aimed to review the past, present, and future opinions on AKI kidneys. (2) Methods: A PubMed search was conducted for topics relevant to AKI kidney transplantation. (3) Results: Current short- and long-term data on AKI kidneys have demonstrated good outcomes including favorable graft function and survival. The role of procurement biopsies is controversial, but they have been shown to be beneficial in AKI kidneys by allowing clinicians to differentiate between reversible tubular injury and irreversible cortical necrosis. Machine perfusion has also been applied to AKI kidneys and has been shown to reduce delayed graft function (DGF). The incidence of DGF increases with AKI severity and its management can be challenging. Strategies employed to counteract this have included early initiation of dialysis after kidney transplantation, early targeting of adequate immunosuppression levels to minimize rejection risk, and establishment of outpatient dialysis. (4) Conclusions: Despite good outcomes, there continue to be barriers that impact AKI kidney utilization. Successful strategies have included use of procurement biopsies or machine perfusion and expectant management of DGF. With increasing experience, better use of AKI kidneys can result in additional opportunities to expand the donor pool. |
| first_indexed | 2024-03-11T00:01:24Z |
| format | Article |
| id | doaj.art-81b15c3c39964103ac5d6cea5af8afe8 |
| institution | Directory Open Access Journal |
| issn | 2039-7283 |
| language | English |
| last_indexed | 2024-03-11T00:01:24Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj.art-81b15c3c39964103ac5d6cea5af8afe82023-11-19T00:42:49ZengMDPI AGClinics and Practice2039-72832023-08-0113494495810.3390/clinpract13040086Past, Current, and Future Perspectives on Transplanting Acute Kidney Injury KidneysRachana Punukollu0Margaret Ryan1Suman Misra2Pooja Budhiraja3Stephanie Ohara4Kayla Kumm5Giselle Guerra6Kunam S. Reddy7Raymond Heilman8Caroline C. Jadlowiec9Division of Transplant Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ 85054, USADivision of Anatomic Pathology, Mayo Clinic, Phoenix, AZ 85054, USADivision of Nephrology, Mayo Clinic, Phoenix, AZ 85054, USADivision of Nephrology, Mayo Clinic, Phoenix, AZ 85054, USADivision of Surgery, Valleywise Health Medical Center, Creighton University, Phoenix, AZ 85008, USADivision of Transplant Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ 85054, USADivision of Nephrology, Miami Transplant Institute, Miami, FL 33136, USADivision of Transplant Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ 85054, USADivision of Nephrology, Mayo Clinic, Phoenix, AZ 85054, USADivision of Transplant Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ 85054, USA(1) Background: Acute kidney injury (AKI) kidneys have high non-utilization rates due to concerns regarding unfavorable outcomes. In this paper, we aimed to review the past, present, and future opinions on AKI kidneys. (2) Methods: A PubMed search was conducted for topics relevant to AKI kidney transplantation. (3) Results: Current short- and long-term data on AKI kidneys have demonstrated good outcomes including favorable graft function and survival. The role of procurement biopsies is controversial, but they have been shown to be beneficial in AKI kidneys by allowing clinicians to differentiate between reversible tubular injury and irreversible cortical necrosis. Machine perfusion has also been applied to AKI kidneys and has been shown to reduce delayed graft function (DGF). The incidence of DGF increases with AKI severity and its management can be challenging. Strategies employed to counteract this have included early initiation of dialysis after kidney transplantation, early targeting of adequate immunosuppression levels to minimize rejection risk, and establishment of outpatient dialysis. (4) Conclusions: Despite good outcomes, there continue to be barriers that impact AKI kidney utilization. Successful strategies have included use of procurement biopsies or machine perfusion and expectant management of DGF. With increasing experience, better use of AKI kidneys can result in additional opportunities to expand the donor pool.https://www.mdpi.com/2039-7283/13/4/86acute kidney injurykidney transplantdelayed graft functionorgan shortagedonor pool |
| spellingShingle | Rachana Punukollu Margaret Ryan Suman Misra Pooja Budhiraja Stephanie Ohara Kayla Kumm Giselle Guerra Kunam S. Reddy Raymond Heilman Caroline C. Jadlowiec Past, Current, and Future Perspectives on Transplanting Acute Kidney Injury Kidneys Clinics and Practice acute kidney injury kidney transplant delayed graft function organ shortage donor pool |
| title | Past, Current, and Future Perspectives on Transplanting Acute Kidney Injury Kidneys |
| title_full | Past, Current, and Future Perspectives on Transplanting Acute Kidney Injury Kidneys |
| title_fullStr | Past, Current, and Future Perspectives on Transplanting Acute Kidney Injury Kidneys |
| title_full_unstemmed | Past, Current, and Future Perspectives on Transplanting Acute Kidney Injury Kidneys |
| title_short | Past, Current, and Future Perspectives on Transplanting Acute Kidney Injury Kidneys |
| title_sort | past current and future perspectives on transplanting acute kidney injury kidneys |
| topic | acute kidney injury kidney transplant delayed graft function organ shortage donor pool |
| url | https://www.mdpi.com/2039-7283/13/4/86 |
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