title: Successful transplantation of kidneys from deceased donors with acute renal failure: Three-year results.
abstract: BACKGROUND
  Kidneys from deceased donors with acute renal failure (ARF) are generally not accepted for transplantation because of the expected poor outcome. This prospective study examined the utilization of kidneys from donors with ARF for transplantation and the outcomes.
  
  
  METHODS
  Fifty-five kidneys from donors with ARF were transplanted. The outcome was compared with concurrent and matched 55 recipients of standard criteria donor (SCD) kidneys and 55 expanded criteria donor (ECD) kidneys. ARF kidneys were accepted from donors aged <50 years, a negative history for kidney disease, and a negative pretransplant biopsy for chronic structural changes. The immunosuppression was similar in all three groups. The outcome measurements included three-year patient and graft survival, biopsy-proven acute rejection (BPAR), subclinical acute rejection (SCAR), and chronic allograft nephropathy (CAN), serum creatinine, and creatinine clearance.
  
  
  RESULTS
  Three-year patient and graft survival was 90% and 90% in ARF group, 100% and 89% in SCD group and 83% and 66% in ECD group. BPAR and SCAR were comparable in the groups but CAN was significantly higher in ECD group. Mean serum creatinine levels were 1.9+/-1.1, 1.9+/-0.9, and 2.2+/-1.3 mg/dl and mean creatinine clearances were 66+/-15, 68+/-14, and 58+/-10 mls/minute in ARF, SCD, and ECD groups, respectively (SCD and ARF vs. ECD P = 0.04).
  
  
  CONCLUSIONS
  Transplantation of kidneys from selected deceased donors with ARF provides comparable survival and function compared to kidneys from non-ARF donors and may be considered for transplantation to expand the donor pool to overcome the current acute shortage of kidneys.
authors.affiliation: Division of Transplantation, Drexel University College of Medicine, Philadelphia, PA 19102, USA. akumar01@drexelmed.edu
authors.forename: Mysore S
authors.initials: MS
authors.lastname: Anil Kumar
authors.forename: Shahid M
authors.initials: SM
authors.lastname: Khan
authors.forename: Sandeep
authors.initials: S
authors.lastname: Jaglan
authors.forename: Michael
authors.initials: M
authors.lastname: Heifets
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Moritz
authors.forename: Muhammad I
authors.initials: MI
authors.lastname: Saeed
authors.forename: Billie
authors.initials: B
authors.lastname: Fyfe
authors.forename: Nedjema
authors.initials: N
authors.lastname: Sustento-Reodica
authors.forename: Aparna
authors.initials: A
authors.lastname: Kumar
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality / Q000503:physiopathology; D000328:Adult; D000368:Aged; D046148:Donor Selection; D006084:Graft Rejection / Q000209:etiology / Q000401:mortality / Q000473:pathology; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000502:physiology; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome