Single Graft Utilization From Donors With Severe Acute Kidney Injury After Circulatory Death
Abstract. Chronic shortages of organs for transplantation have led to the use of marginal kidneys from donors after circulatory death with acute kidney injury (AKI), but the utilization of kidneys with severe AKI is not well established. We retrospectively analyzed eight kidney transplantation (KTx)...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2018-04-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000768 |
| _version_ | 1811334833967726592 |
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| author | Yusuke Tomita, MD Kazuhiro Iwadoh, MD Yuichi Ogawa, MD Katsuyuki Miki, MD Kotaro Kai, MD Akihito Sannomiya, MD Toru Murakami, MD Ichiro Koyama, MD Kumiko Kitajima, MD Ichiro Nakajima, MD Shohei Fuchinoue, MD |
| author_facet | Yusuke Tomita, MD Kazuhiro Iwadoh, MD Yuichi Ogawa, MD Katsuyuki Miki, MD Kotaro Kai, MD Akihito Sannomiya, MD Toru Murakami, MD Ichiro Koyama, MD Kumiko Kitajima, MD Ichiro Nakajima, MD Shohei Fuchinoue, MD |
| author_sort | Yusuke Tomita, MD |
| collection | DOAJ |
| description | Abstract. Chronic shortages of organs for transplantation have led to the use of marginal kidneys from donors after circulatory death with acute kidney injury (AKI), but the utilization of kidneys with severe AKI is not well established. We retrospectively analyzed eight kidney transplantation (KTx) cases from donation after circulatory death (DCD) with terminal creatinine (t-Cr) concentrations higher than 10.0 mg/dL and/or oliguria for more than 5 days (AKI network criteria: stage III). Although all patients showed delayed graft function, no cases of primary nonfunction (PNF) were found. Five patients maintained stable renal function for approximately 15.5, 10, 10, 5, and 0.5 years after KTx. Only 1 patient showed biopsy-proven acute rejection. Also, 2 patients developed graft failure: one attributable to chronic antibody mediated rejection at 11.3 years after KTx, and one attributable to recurrence of IgA nephropathy at 4.6 years after KTx. Kidneys with AKI stage III yielded great outcomes without the risk of primary nonfunction and rejection. Although the AKI kidneys were associated with delayed graft function, these results suggest that even the most severe kidneys with AKI stage III from DCD donors can be considered a valid alternative for recipients on a waiting list for KTx. |
| first_indexed | 2024-04-13T17:15:02Z |
| format | Article |
| id | doaj.art-d0069f1c95384324829d698a12d7ec2a |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-04-13T17:15:02Z |
| publishDate | 2018-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-d0069f1c95384324829d698a12d7ec2a2022-12-22T02:38:10ZengWolters KluwerTransplantation Direct2373-87312018-04-0144e35510.1097/TXD.0000000000000768201804000-0005Single Graft Utilization From Donors With Severe Acute Kidney Injury After Circulatory DeathYusuke Tomita, MD0Kazuhiro Iwadoh, MD1Yuichi Ogawa, MD2Katsuyuki Miki, MD3Kotaro Kai, MD4Akihito Sannomiya, MD5Toru Murakami, MD6Ichiro Koyama, MD7Kumiko Kitajima, MD8Ichiro Nakajima, MD9Shohei Fuchinoue, MD101 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.1 Tokyo Women’s Medical University, Department of Surgery III, Tokyo, Japan.Abstract. Chronic shortages of organs for transplantation have led to the use of marginal kidneys from donors after circulatory death with acute kidney injury (AKI), but the utilization of kidneys with severe AKI is not well established. We retrospectively analyzed eight kidney transplantation (KTx) cases from donation after circulatory death (DCD) with terminal creatinine (t-Cr) concentrations higher than 10.0 mg/dL and/or oliguria for more than 5 days (AKI network criteria: stage III). Although all patients showed delayed graft function, no cases of primary nonfunction (PNF) were found. Five patients maintained stable renal function for approximately 15.5, 10, 10, 5, and 0.5 years after KTx. Only 1 patient showed biopsy-proven acute rejection. Also, 2 patients developed graft failure: one attributable to chronic antibody mediated rejection at 11.3 years after KTx, and one attributable to recurrence of IgA nephropathy at 4.6 years after KTx. Kidneys with AKI stage III yielded great outcomes without the risk of primary nonfunction and rejection. Although the AKI kidneys were associated with delayed graft function, these results suggest that even the most severe kidneys with AKI stage III from DCD donors can be considered a valid alternative for recipients on a waiting list for KTx.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000768 |
| spellingShingle | Yusuke Tomita, MD Kazuhiro Iwadoh, MD Yuichi Ogawa, MD Katsuyuki Miki, MD Kotaro Kai, MD Akihito Sannomiya, MD Toru Murakami, MD Ichiro Koyama, MD Kumiko Kitajima, MD Ichiro Nakajima, MD Shohei Fuchinoue, MD Single Graft Utilization From Donors With Severe Acute Kidney Injury After Circulatory Death Transplantation Direct |
| title | Single Graft Utilization From Donors With Severe Acute Kidney Injury After Circulatory Death |
| title_full | Single Graft Utilization From Donors With Severe Acute Kidney Injury After Circulatory Death |
| title_fullStr | Single Graft Utilization From Donors With Severe Acute Kidney Injury After Circulatory Death |
| title_full_unstemmed | Single Graft Utilization From Donors With Severe Acute Kidney Injury After Circulatory Death |
| title_short | Single Graft Utilization From Donors With Severe Acute Kidney Injury After Circulatory Death |
| title_sort | single graft utilization from donors with severe acute kidney injury after circulatory death |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000768 |
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